Common Complications of botulism injection part 4

Views: 2     Author: Site Editor     Publish Time: 2022-09-09      Origin: Site

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Lower eyelid laxity: The injection of crow's feet is too medial or the injection dose of the lower eyelid is too large, which will cause the lower orbicularis muscle to relax.

Visual effects: It is common in the inward deviation of the injection point of the crow's feet, and the excessive dose penetrates into the extraocular muscles, thereby affecting the eye movement. Too many injections, too deep and penetration into the forehead lines and glabellar lines may also have a certain impact on the extraocular muscles.

The extraocular muscles include four rectus muscles (superior rectus, inferior rectus, medial rectus, and lateral rectus) and two oblique muscles (superior oblique and inferior oblique), which are responsible for eye movement. The normal movement of the eyeball is coordinated by the above-mentioned six extraocular muscles. For example, when looking up, both the upper eyelid muscles and the superior oblique muscles must be contracted at the same time. Lateral view is the contraction of the lateral rectus on one side and the medial rectus on the other. When the eyes converge on the midline, the medial rectus muscles of both eyes must be contracted at the same time. If there is a problem with the injection, it may cause blurred vision, difficulty in focusing, ghosting, photophobia, tearing, and pupil dilation.


complicationofbotoxinjectionDistorted expression: The facial expression muscles on the upper face are the frontalis muscle and the muscles around the eyes, which are prone to wrinkles. The treatment effect of botulinum toxin is the best. The comprehensive application of wrinkle removal on the upper face is widely used.

Due to the extremely complex language function, the muscles around the mouth are highly differentiated in structure, forming a complex set of muscle groups with symmetrical distribution, which play an important role in human feeding, sucking, playing, language and expression.

The facial expression muscles of the midface are the muscles above the orbicularis oris, which have poor wrinkle-removal effect. After injection of botulinum toxin, it is easy to have a stiff or asymmetrical expression. It is only injected in a few special cases such as gummy smile. The lower facial expression muscle is the muscle group above the orbicularis oris muscle, and there are many cases of injection. Doctors need to be careful with small dose injection and proper application, which can get the effects of mental muscle release and mouth corner lift.


It is precisely because the facial expression muscles have a clear division of labor and complex distribution, so slightly inadvertently, the injection site is wrong, the bilateral injection is asymmetric (including the asymmetry of dose, point, and level), or the injection volume is too much. Peripheral muscles can cause unnatural facial expressions and different performances. It is often manifested as stiff dynamic expressions, abnormal contractions, or asymmetry in various situations, especially when smiling.


Calf soreness: Mild soreness in the calf is a normal phenomenon after botulinum toxin injection into the thin calf, and severe soreness is closely related to the excessive dosage of botulinum toxin and the tolerance of the individual's constitution. 

The calf is the muscle that carries the weight of the whole body. The injection dose is small and has little effect. If the injection dose is too large, it will have some impact on the walking function. Therefore, try not to inject needles for small legs!

The calf is slightly weak, and there are no obvious symptoms when walking normally. If you go uphill or climb stairs, the soreness will become more obvious. Similar to the soreness after exercise, the amount of exercise is not large, and it can be relieved by a little rest. A small number of patients will feel weak in walking or standing unsteadily, some are subjective psychological feelings of patients, and there is no obstacle to walking in medical examination, and some are due to the atrophy of the muscle group originally used for walking, which is in the compensatory adaptation of the synergistic muscle group. It resolved spontaneously after 3 weeks.