title: Festoon formation after infraorbital botulinum A toxin: a case report.
abstract: 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.
authors.affiliation: La Jolla Spa-MD, La Jolla, California 92037, USA. mgderm@aol.com
authors.forename: Mitchel P
authors.initials: MP
authors.lastname: Goldman
mesh_terms: 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*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A