A Review of Complications Due to the Use of Botulinum Toxin A for Cosmetic Indications

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REVIEW

NON-SURGICAL AESTHETIC

A Review of Complications Due to the Use of Botulinum Toxin A for Cosmetic Indications Nitin Sethi1



Sukhbir Singh2 • Koenraad DeBoulle3 • Eqram Rahman4

Received: 14 August 2020 / Accepted: 5 September 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020

Abstract Background Botulinum toxin A (botulinum toxin A) was found to provide a wide variety of therapeutic and aesthetic benefits as one of the most potent toxins in the world. Injectable remedies, including soft tissue fillers and botulinum toxin, have become very common in wrinkling and face rejuvenation management. While these methods of treatment are relatively safe, serious side effects can occur. In this review, the complications of BoNTA are highlighted. Methods A literature research considered published journal articles (clinical trials or scientific reviews). Electronic databases (PubMed, Scopus, Science Direct) were searched using key terms, and for identification of additional relevant studies, reference lists have also been examined. Only articles published in English were included in this review with a time restriction from 2000 to 2020.

Results There are various injection-related adverse effects associated (AE) with botulinum toxins such as erythema, oedema, pain, ptosis of eyelid or brow and ecchymosis. The overall majority of adverse events identified are mild and temporary. Conclusion As the use of toxins becomes increasingly more common, adverse events can be expected to increase as well. The practitioners need to be aware of such AEs, and the patients should be informed of these before undertaking such procedures. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Keywords Botulinum toxin A  Wrinkles  Complication

& Nitin Sethi [email protected] Sukhbir Singh [email protected] Koenraad DeBoulle [email protected] Eqram Rahman [email protected] 1

Plastic and Cosmetic Surgery, Fortis Hospital Ludhiana, Punjab 141001, India

2

Resplendent the Cosmetic Studio, R-9, GK-1, New Delhi 110048, India

3

Aalst Dermatology Clinic, Aalst, Belgium

4

Department of Plastic and Reconstructive Surgery, University College London and Royal Fre Hospital, Hampstead, London NW3 2QG, UK

Introduction Botulinum toxin A has been created from a toxin and is one of the mammals’ most toxic poisons with a lethal dose of around one nanogram per kg body weight [1]. The therapeutic use of botulinum toxin was introduced about two centuries ago when Justinus Andreas Christian Kerner recognized the effect of botulinum toxin on skeletal muscles, and it’s a parasympathetic function [2]. There are eight serologically distinct botulinum neurotoxins, A, B, C1, C2, D, E, F, G. Seven have been linked to causing paralysis. Human botulism has o