Complications of Botulinum Toxin-A Injection in an Iranian Population

Abstract

Background: The use of botulinum toxin-A is increasing for aesthetic treatments and new reassuring data have been reported in recent studies. The purpose of this study was to evaluate the complications of botulinum toxin-A (BoTo-A) (NEURONOX) injection to eliminate wrinkles in the upper one-third of the face. Methods: The present study was conducted on 235 patients referring to the dermatology clinic of Rasoul Akram hospital in Iran (including 82 men and 153 women with a mean age of 50 years) for the treatment of forehead, frown, and lateral orbital rim wrinkles between 2011 and 2015. The injection level was 35 units of botulinum toxin-A (NEURONOX) for women and 45 for men in the glabella area, and 15 units for women and 20 units for men in the crow's feet area. Results: The complications of botulinum toxin-A injection among 235 subjects were as follows: 1.3% ptosis (n = 3), 1.7% angioneurotic edema (n = 4), 2.1% vasovagal syncope (n = 5), 3.8% haematoma (n = 9), 1.7% diplopia (n = 4), and 2.1% musculoskeletal pain (n = 5). The satisfaction rate of patients with a complication measured one month after injection indicated that 63.3% (19/30) were satisfied with the injection and 36.7% (11/30) were dissatisfied. The satisfaction rate of patients without a complication showed that 91.7% (188/205) were pleased and 8.3% (17/205) were dissatisfied with the injection. Conclusions: According to the findings of this study, the injection of BoTo-A (NEURONOX) to attenuate glabellar lines and the lateral orbital rim was safe and effective. The complications in this study were not serious and generally were transient and self-limiting.