Injection of botulinum toxin causes weakness of targeted muscles, which can last approximately 2-4 months and over this time the effects will diminish. Injection of small amounts of botulinum toxin relaxes the treated muscles and can reduce facial wrinkles such as frown lines. It is injected with a small needle into the targeted muscles. Effects are typically seen in a few days and can take 1-2 weeks to fully develop.
Botulinum toxin-related
- Localised burning or stinging pain during injection
- Blepharoptosis (droopy eyelid)
- Eyebrow ptosis (droopy eyebrow)
- Ectropian of the lower eyelid (eyelid margin eversion)
- Lagophthalmus (incomplete eyelid closure)
- Xerophthalmia (dry eyes)
- Epiphora (excess tearing)
- Diplopia (double vision)
- Impaired blink reflex
- Photophobia (light sensitivity)
- Globe trauma
- Infraorbital festooning (worsening of eyebags)
- Lip ptosis with resultant smile asymmetry
- Oral incompetence with resultant drooling and impaired speaking, eating or drinking
- Cheek flaccidity
- Dysarthria (difficulty articulating)
- Dysphagia (difficulty swallowing)
- Hoarseness
- Neck weakness
- Facial asymmetry, alteration or poor aesthetic result
- Inadequate reduction of wrinkles or lack of intended effect in the treatment area
- Worsening wrinkles in areas adjacent to the treatment area
- Weakening muscles adjacent to the treatment area
- Autoantibodies against botulinum toxin. Autoantibodies may be present or develop after injection, rendering treatments ineffective (1-2% of patients treated for cosmetic indications)
- Extremely rare, immediate hypersensitivity reaction with signs of urticaria, oedema and a remote possibility of anaphylaxis
General Injection-related complications (can be any treatment):
- Pain
- Bruising
- Erythema
- Oedema
- Tenderness
- Headache
- Infection
- Numbness or paresthesia
- Anxiety
- Vasovagal episode and loss of consciousness
For most complications there are no corrective treatments and they spontaneously resolve as botulinum toxin effects diminish.