Severe anaphylactic facial edema after botulinum toxin injections for frontal wrinkles: a case report

Botulinum toxin injections are a popular cosmetic procedure because of their satisfactory results, less downtime, and limited side effects. However, some rare adverse events may occur soon after the procedure. Here, we present the case of a patient who developed severe facial edema after her first botulinum toxin injections for frontal wrinkles. A 28-year-old female was injected with 20 units of botulinum toxin to eliminate her frontal and glabella wrinkles. The injection was completed smoothly and uneventfully. Six hours post injection, the patient’s face started to swell up and redden with a burning feeling, and the swelling progressively worsened progressively. She was diagnosed with Type I hypersensitivity after the level of immunoglobulin E in her blood serum was tested. Her symptoms were controlled by treatment with systemic corticosteroids and antihistamines in the next two days and the patient was cured with no recurrence during a 2-year follow-up. This case demonstrates the possibility of developing severe facial edema after botulinum toxin injection. Treatment with systemic corticosteroids and oral antihistamines would help to control this allergic adverse effect.