# High-Resolution Ultrasound for Complications of Botulinum Toxin Use: A Case Series and Literature Review

## TL;DR

This paper explores how high-resolution ultrasound can help diagnose complications from botulinum toxin injections, using four clinical cases to highlight its effectiveness.

## Contribution

The paper introduces the use of high-resolution ultrasound as a diagnostic tool for botulinum toxin complications through a case series.

## Key findings

- High-resolution ultrasound accurately characterizes complications from botulinum toxin injections.
- The study presents four cases showing ultrasound's role in identifying issues like ptosis and pseudoaneurysm.
- Ultrasound provides effective guidance for managing both aesthetic and functional complications.

## Abstract

Botulinum toxin (BTX) has revolutionized both aesthetic and therapeutic medicine by selectively inhibiting acetylcholine release at the neuromuscular junction, inducing localized muscle relaxation. However, its use can be associated with various complications. As a diagnostic modality, high-resolution ultrasound can better characterize these complications.

Here, we present four clinical cases of complications associated with the application of BTX, along with their corresponding ultrasonographic findings. In this study, cases were selected randomly, irrespective of the timing of BTX injections, to illustrate a spectrum of complications observed in clinical practice.

Despite its benefits, BTX can have adverse effects ranging from mild to severe, including aesthetic and functional complications, such as hematoma, ptosis, facial asymmetry, nodules, or pseudoaneurysm. High-resolution ultrasound emerges as a crucial tool in the multidisciplinary management of these complications, allowing for accurate evaluation and effective therapeutic guidance.