Complications in the cosmetic use of botulinum toxin type A: Prevention and management

Abstract

Botulinum toxin type A (BTX-A) has become the most frequently requested nonsurgical procedure performed around the world. The use of BTX-A in cosmetics has expanded greatly since its approval by the Food and Drug Administration for reduction of glabellar rhytids. Experienced clinicians have been using BTX-A in other areas off-label to improve the appearance of rhytids and facial harmony. Adverse effects associated with BTX-A are rare and tend to be mild and temporary, such as bruising, swelling, and pain at injection sites. More serious complications, such as brow ptosis or eyelid ptosis, can occur. These complications can be minimized by a thorough understanding of the anatomy of the face and careful injection technique, which will be outlined in this article.