Blepharoptosis as a Complication of Botulinum Toxin Injection: Understanding the Role of Neurovascular Variations

Since the first approval of Botulinum Toxin A (BTX) for the treatment of eye muscle disorders in 1989, the use of BTX for cosmetic purposes has increased sharply. The procedure can lead to various complications. Fortunately, most of the complications of BTX cosmetic injection are generally mild and temporary. One of the more serious complications that can occur is upper eyelid ptosis. Although this type of ptosis is usually self-limiting and does not typically lead to the development of any secondary adverse effects, it is important to note that upper eyelid ptosis can be associated with impaired vision, diplopia, and hyperemia. In serious cases, series of treatments and procedures can be used to expedite recovery. Most of these complications can be avoided through the skill and knowledge, precise anatomical analysis of the individual patient, and thorough understanding of the product. The rate of ptosis due to cosmetic BTX injection can be as high as 6.5% if. However, even with appropriate care, there is still a small chance of ptosis that may be associated with anatomical and neurovascular variations. Provided that the necessary guidelines are followed, BTX injection remains a more effective and safer cosmetic procedure than its surgical counterpart.