ReviewJournal of cosmetic dermatology2021
Botulinum toxin-induced blepharoptosis: Anatomy, etiology, prevention, and therapeutic options.
Review in Journal of cosmetic dermatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 68 citations in OpenAlex.
- A Phase III Clinical Study of the Efficacy and Safety of Botulinum Toxin Type A (MASPORT) with DYSPORT for the Treatment of Glabellar Lines.Aesthetic plastic surgery · 2024Trial
- Methodology for preventing Botulinum toxin-A eyelid ptosis: Risk index derivation, safety rules, and evidence-graded management algorithm.World journal of methodology · 2026Review
- Review
- The Neuromuscular Junction Distribution in the Upper Face: An Anatomy-to-Practice Review to Inform Botulinum Toxin Type A Treatment Planning.Journal of cosmetic dermatology · 2026Review
- Topical imiquimod in the management of botulinum toxin-induced upper eyelid ptosis: A case series.JAAD case reports · 2026Article
- Evaluation of blepharoptosis, meibomian gland morphology, and dry eye parameters in older individuals with sarcopenia: a case-control study.International ophthalmology · 2026Article
- Ultrasound-guided preseptal hydrodissection with 5% dextrose in water for persistent botulinum toxin-associated ptosis: a technical protocol.Frontiers in ophthalmology · 2026Article
- Management of Complications Following Botulinum Toxin Facial Injections: A Narrative Review.Cureus · 2026Review
- Real-world landscape of drug-related ocular injuries: a retrospective pharmacovigilance study.Frontiers in pharmacology · 2026Article
- From Incision to Healing: An Evidence-Based Review of Scar Optimization in Upper Blepharoplasty.Aesthetic plastic surgery · 2026Review
- Article
- Proactive Aesthetic Strategies: Evaluating the Preventive Role of Botulinum Toxin in Facial Aging.Muscles (Basel, Switzerland) · 2025Review
- Photobiomodulation as a Hypothetical Strategy to Reverse Botulinum Toxin Effects: Exploring the Neuroregenerative Mechanisms and Translational Potential.Life (Basel, Switzerland) · 2025Review
- Article
- Botulinum Toxin: A Non-surgical Approach for Non-myasthenic Mild-to-Moderate Blepharoptosis Treatment.Aesthetic plastic surgery · 2025Article
- Unilateral Blepharoptosis Combined With Malignant Exophthalmos After Botulinum Toxin Injection to Glabellar Lines: A Case Report.Journal of cosmetic dermatology · 2025Article
- The Esthetic Use of Botulinum Toxins in Cancer Patients: Providing a Foundation for Future Indications.Toxins · 2025Review
- Dimension, Location and Clinical Importance of Supraorbital Foramen and Notch: A Combined Cadaveric and Dry Skull Study.Aesthetic plastic surgery · 2025Article
- Anatomy, Etiology, Management, and Medico-Legal Implications of Botulinum-induced Blepharoptosis.Current reviews in clinical and experimental pharmacology · 2025Review
- Real-world large sample evaluation of drug-related blepharoptosis: a pharmacovigilance analysis of the FDA Adverse Event Reporting System database.Therapeutic advances in drug safety · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBotulinum toxin A (BoNT-A) has grown tremendously in aesthetic dermatology since 2002 when the United States Food and Drug Administration (FDA) first approved its use for treating moderate-to-severe glabellar lines. Blepharoptosis, due to local spread of toxin, is a reported side effect of BoNT-A which, although rare, more frequently occurs among inexperienced practitioners.
objectivesThe purpose of this review is to highlight the causes and management of eyelid ptosis secondary to BoNT-A administration including new anatomic pathways for BoNT-A spread from the brow area to the levator palpebrae superioris muscle.
methodsA literature search was conducted using electronic databases (PubMed, Science Direct, MEDLINE, Embase, CINAHL, EBSCO) regarding eyelid anatomy and the underlying pathogenesis, presentation, prevention, and treatment of eyelid ptosis secondary to BoNT-A. Anatomic dissection has been performed to assess the role of neurovascular pedicles and supraorbital foramen anatomic variations.
resultsBlepharoptosis occurs due to weakness of the levator palpebrae superioris muscle. Mean onset is 3-14 days after injection and eventually self-resolves after the paralytic effect of BoNT-A wanes. Administration of medications, such as oxymetazoline hydrochloride or apraclonidine hydrochloride eye drops, anticholinesterase agents, or transdermal BoNT-A injections to the pre-tarsal orbicularis, can at least partially reverse eyelid ptosis. Anatomic study shows that a supraorbital foramen may be present in some patients and constitutes a shortcut from the brow area directly into the orbital roof, following the supraorbital neurovascular pedicle.
conclusionProviders should understand the anatomy and be aware of the causes and treatment for blepharoptosis when injecting BoNT-A for the reduction of facial wrinkles. Thorough anatomic knowledge of the supraorbital area and orbital roof is paramount to preventing incorrect injection into "danger zones," which increase the risk of eyelid ptosis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.