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Cosmetic complications: rare and serious events following botulinum toxin and soft tissue filler administration.

BACKGROUND
Botulinum toxin (BTX) and soft tissue fillers continue to gain in popularity due to their safety, affordability, quick effects, and short recovery times. With the excellent safety profile of BTX and soft tissue fillers, patients may develop a nonchalant attitude towards treatment with injectables. However, it is important for both patient and physician to be familiar with all the possible complications, both common and uncommon.


OBJECTIVE
This article aims to review the rare but serious complications associated with the injectables used in cosmetic dermatology, and the pathogenesis, diagnosis, and management of each.


METHODS AND MATERIALS
A literature review for case reports pertaining to rare adverse events following botulinum toxin or soft tissue fillers was performed using the MEDLINE database.


RESULTS
Complications of BTX included dry eye syndrome, strabismus and diplopia, superficial temporal artery pseudoaneurysm, neck weakness, hoarseness, and dysphagia. Complications associated with soft tissue fillers included tissue necrosis, inflammatory nodules, hypersensitivity reaction, and blindness and cerebral ischemia.


CONCLUSION
The injector should be comfortable in diagnosing and managing the above complications, and the patient should be counseled about these potentially harmful adverse events prior to injection.