Mitchel P Goldman1. 1. La Jolla Spa-MD, La Jolla, California 92037, USA. mgderm@aol.com
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. CONCLUSION: Caution must be exercised when performing infraocular injection of botulinum toxin A in patients with prior transtarsal lower lid blepharoplasty.
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. CONCLUSION: Caution must be exercised when performing infraocular injection of botulinum toxin A in patients with prior transtarsal lower lid blepharoplasty.