A review of complication rates following botulinum toxin A (BoNT-A) injections in the glabellar region and forehead found that 16% of patients experience adverse events, including headache, local skin reactions and facial neuromuscular symptoms.
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For their study, published in the May 2022 issue of the Aesthetic Surgery Journal, David Zargaran, MBBS, BSc, et al, searched MEDLINE and EMBASE for studies reporting complications after cosmetic BoNT-A in the glabellar or in the forehead region. Of 556 identified articles, 24 were included in the final quantitative analysis, with 4,268 BoNT-A injection sessions and 1,234 placebos.
The most frequently observed treatment-related complications in the BoNT-A groups included headache, local skin reactions and facial neuromuscular symptoms with an overall BoNT-A complication rate of 16%.
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The odds ratio of developing complications from abobotulinum toxin injections compared with placebo was 1.62 (1.15, 2.27; P > 0.05) and that from onabotulinum toxin injections compared with placebo was 1.34 (0.52, 3.48; P > 0.05). In 30% of the studies, the injectors were reported as doctors. The training and/or licensing status of the practitioner was not reported in the remaining 70% of studies reviewed.
The authors noted that most complications are mild and transient, and cosmetic BoNT-A injections in the glabellar and forehead region appear to be safe. However, there is a lack of consistency both in the reporting of complications and the definition of treatment-related complications in the literature.