Adverse Events and Botulinum Toxin Florence Masson Cornavin Dermatology Center (CDC), Geneva, Switzerland Botulinum toxin is presented in sterile vials, containing powder.The powder must be diluted with saline before being injected. Three BTs are launched on the French market: Botox/Vistabel (Allergan), Dysport/Azzalure (Ipsen, Galderma), Xeomin/Bo-couture (Merz). Some traces of proteins may induce an allergic reaction (exceptionally). Most of adverse events are due to the injection technique: pain, bruising, misplacement… Treating the upper face needs expertise, otherwise asymmetry, Mephisto sign, “Botox” lines, ectropion, ptosis of the upper lid and worst of all, diplopia may occur. Treating the lower face is much more risky, because the large number of muscles. Asymmetry of the mouth, dysphonia and dysphagia are not unusual for a beginner. All these incidents and complications will be explained, how to avoid them and eventually how to treat them.
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