Complications of Botulinum Toxin-A Injection in an Iranian Population

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 82menand 153womenwith ameanage 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 botulinumtoxin-A injectionamong235 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.