Facial Plast Surg 2022; 38(02): 111-115
DOI: 10.1055/s-0041-1741531
Original Article

Botulinum Toxin Type A: Adverse Events and Management

Maurizio Cavallini
1   Operative Unit of Dermatology and Dermato-Surgery, Centro Diagnostico Italiano Hospital, Milan, Italy
,
Marco Papagni
2   Italian Scientific Society of Aesthetic Medicine, Milan, Italy
,
Riccardo Lazzari
2   Italian Scientific Society of Aesthetic Medicine, Milan, Italy
,
Adriano Santorelli
3   Academy of Aesthetic Sciences, Naples, Italy
› Author Affiliations

Abstract

Aesthetic medicine is witnessing an increasing exploitation of all the procedures. The demand has never been higher than it is today. The number of practitioners is also increasing year by year. Consequently complications and other kinds of related troubles and procedures are also rising. Never like today is fundamental, in case of troubles, how to properly manage with the most frequent issues. In aesthetic medicine field, botulinum toxin procedures are the safest. Lot of patients are worried about botulinum toxin despite the available scientific literature. Rare short-term complications are observed. In the most of cases, nothing severe occurs if the international recommendations and the most recent guidelines are closely followed, the majority of them are injection related. This study is a review of rare or common problems that can occur and how to manage or solve the situations.



Publication History

Article published online:
07 February 2022

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  • References

  • 1 Dover JS, Monheit G, Greener M, Pickett A. Botulinum toxin in aesthetic medicine: myths and realities. Dermatol Surg 2018; 44 (02) 249-260
  • 2 Park MY, Ahn KY. Scientific review of the aesthetic uses of botulinum toxin type A. Arch Craniofac Surg 2021; 22 (01) 1-10
  • 3 Zargaran D, Zoller FE, Zargaran A, Mosahebi A. Complications of facial cosmetic botulinum toxin A injection: analysis of the UK Medicines & Healthcare Products Regulatory Agency registry and literature review. J Plast Reconstr Aesthet Surg 2021; Jun 17; S1748-6815 (21) 00332-00336
  • 4 Kroumpouzos G, Kassir M, Gupta M, Patil A, Goldust M. Complications of botulinum toxin a: an update review. J Cosmet Dermatol 2021; 20 (06) 1585-1590
  • 5 Sethi N, Singh S, DeBoulle K, Rahman E. A review of complications due to the use of botulinum toxin A for cosmetic indications. Aesthetic Plast Surg 2021; 45 (03) 1210-1220
  • 6 Tian X, Gao L, Fu G. et al. A rare case of severe systemic life-threatening botulism caused by a local botulinum toxin-A injection. JAAD Case Rep 2020; 6 (09) 854-857
  • 7 Chertow DS, Tan ET, Maslanka SE. et al. Botulism in 4 adults following cosmetic injections with an unlicensed, highly concentrated botulinum preparation. JAMA 2006; 296 (20) 2476-2479
  • 8 Fan KL, Wang YL, Chu G, Leung LP. Delayed antitoxin treatment of two adult patients with botulism after cosmetic injection of botulinum type A toxin. J Emerg Med 2016; 51 (06) 677-679
  • 9 Foissac R, Benatar MJ. Influence of botulinum toxin type A esthetic injections on facial expressions. J Cosmet Dermatol 2021; 20 (05) 1405-1410
  • 10 Raspaldo H, Baspeyras M, Bellity P. et al; Consensus Group. Upper- and mid-face anti-aging treatment and prevention using onabotulinumtoxin A: the 2010 multidisciplinary French consensus—part 1. J Cosmet Dermatol 2011; 10 (01) 36-50
  • 11 Lorenc ZP, Kenkel JM, Fagien S. et al. Consensus panel's assessment and recommendations on the use of 3 botulinum toxin type A products in facial aesthetics. Aesthet Surg J 2013; 33 (suppl I): 35S-40S
  • 12 Krasilnikova O, Pozdnyakova M. Innovative approach to aesthetical medicine services quality assessment. J Cosmet Dermatol 2021; 20 (02) 636-646
  • 13 Bertossi D, Cavallini M, Cirillo P. et al. Italian consensus report on the aesthetic use of onabotulinum toxin A. J Cosmet Dermatol 2018; 17 (05) 719-730
  • 14 Borba A, Matayoshi S, Rodrigues M. Avoiding complications on the upper face treatment with botulinum toxin: a practical guide. Aesthetic Plast Surg 2022; 46 (01) 385-394
  • 15 Hexsel D, Brum C, do Prado DZ. et al. Field effect of two commercial preparations of botulinum toxin type A: a prospective, double-blind, randomized clinical trial. J Am Acad Dermatol 2012; 67 (02) 226-232
  • 16 Kranz G, Haubenberger D, Voller B. et al. Respective potencies of Botox and Dysport in a human skin model: a randomized, double-blind study. Mov Disord 2009; 24 (02) 231-236
  • 17 Renga M. A personalized treatment approach of frontalis muscle with botulinum toxin A (Bont-A) related to functional anatomy: case studies. J Cosmet Laser Ther 2020; 22 (02) 100-106
  • 18 Angelo-Khattar M. A novel onabotulinumtoxin A treatment technique to obtain predictable outcomes in eyebrow position and shape. Clin Cosmet Investig Dermatol 2020; 13: 781-787
  • 19 Nagendran ST, Ali MJ, Dogru M, Malhotra R. Complications and adverse effects of periocular aesthetic treatments. Surv Ophthalmol 2021; DOI: 10.1016/j.survophthal.2021.04.009.
  • 20 Raveendran SS, Anthony DJ. Classification and morphological variation of the frontalis muscle and implications on the clinical practice. Aesthetic Plast Surg 2021; 45 (01) 164-170
  • 21 Du YX, Wu L, Shen Y. Advances in iatrogenic eye complications caused by facial cosmetic injections. Zhonghua Yan Ke Za Zhi 2021; 57 (05) 391-395
  • 22 Vijayakumar D, Wijemanne S, Jankovic J. Treatment of blepharospasm with apraclonidine. J Neurol Sci 2017; 372: 57-59
  • 23 Heydenrych I. The treatment of facial asymmetry with botulinum toxin: current concepts, guidelines, and future trends. Indian J Plast Surg 2020; 53 (02) 219-229
  • 24 Witmanowski H, Błochowiak K. The whole truth about botulinum toxin—a review. Postepy Dermatol Alergol 2020; 37 (06) 853-861
  • 25 Kutschenko A, Weisemann J, Kollewe K. et al. Botulinum neurotoxin serotype D—a potential treatment alternative for BoNT/A and B non-responding patients. Clin Neurophysiol 2019; 130 (06) 1066-1073
  • 26 Bellows S, Jankovic J. Immunogenicity associated with botulinum toxin treatment. Toxins (Basel) 2019; 11 (09) 491
  • 27 de Maio M, DeBoulle K, Braz A, Rohrich RJ. Alliance for the Future of Aesthetics Consensus Committee. Facial assessment and injection guide for botulinum toxin and injectable hyaluronic acid fillers: focus on the midface. Plast Reconstr Surg 2017; 140 (04) 540e-550e
  • 28 Chang YS, Chang CC, Shen JH, Chen YT, Chan KK. Nonallergic eyelid edema after botulinum toxin type a injection: case report and review of literature. Medicine (Baltimore) 2015; 94 (38) e1610
  • 29 Auada Souto MP, Souto LRM. An unusual adverse event of botulinum toxin injection in the lower face. J Cosmet Dermatol 2021; 20 (05) 1381-1384
  • 30 Gong X, Huang H, Gu C. et al. Individual factors of botulinum type A in treatment of gummy smile: a prospective study. Aesthet Surg J 2021; 41 (07) NP842-NP850
  • 31 Li Y, Chong Y, Yu N, Dong R, Long X. The use of botulinum toxin A in upper lip augmentation. J Cosmet Dermatol 2021; 20 (01) 71-74
  • 32 Yeh YT, Peng JH, Peng HP. Literature review of the adverse events associated with botulinum toxin injection for the masseter muscle hypertrophy. J Cosmet Dermatol 2018; 17 (05) 675-687
  • 33 Bae H, Kim J, Seo KK, Hu KS, Kim ST, Kim HJ. Comparison between conventional blind injections and ultrasound-guided injections of botulinum toxin type A into the masseter: a clinical trial. Toxins (Basel) 2020; 12 (09) 588