Festoon formation after infraorbital botulinum A toxin: a case report.
BACKGROUND
An injection of the lateral canthus and infraorbital fold is commonly used to soften wrinkles and widen the eye.


OBJECTIVE
To illustrate a case report of festooning and to hypothesize as to its cause.


METHODS
A 56-year-old man developed festooning of the infraocular area after injection of botulinum toxin A.


RESULTS
Prior lower lid blepharoplasty with separation of the infraorbital orbicularis oculi muscle may have weakened the muscle enough to cause festooning with further weakening of the muscle through botulinum toxin A injection.


CONCLUSIONS
Caution must be exercised when performing infraocular injection of botulinum toxin A in patients with prior transtarsal lower lid blepharoplasty.
Goldman
Mitchel P
MP
La Jolla Spa-MD, La Jolla, California 92037, USA. mgderm@aol.com
D019882:Blepharoplasty / Q000009:adverse effects; D019274:Botulinum Toxins, Type A / Q000009:adverse effects*; D005141:Eyelid Diseases / Q000139:chemically induced* / Q000209:etiology; D005143:Eyelids / Q000294:innervation / Q000503:physiopathology; D005158:Facial Paralysis / Q000139:chemically induced* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000009:adverse effects*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A