Keeping up appearances: Don't frown upon the effects of botulinum toxin injections in facial muscles.
Level 5 - mechanism / opinion, no new human data
Narrative review of clinical and electrophysiological literature without systematic search or meta-analysis.
PubMed 37681120 · doi:10.1016/j.cnp.2023.05.005
What was done
Narrative review evaluating the literature on the long-term neurophysiological consequences of aesthetic botulinum toxin (BoNT) injections into facial muscles (such as glabellar, forehead, and periorbital lines), focusing on muscle changes, toxin diffusion, and the application of electrophysiological testing in clinical differential diagnosis.
What was found
The abstract reports no quantitative values or statistical comparisons. Qualitatively, it notes that cosmetic BoNT use frequently exceeds the recommended 2-year duration, resulting in potential muscle atrophy, toxin diffusion to adjacent musculature, and risks of persistent chemical denervation with reduced potential for reinnervation, creating diagnostic pitfalls when evaluating neuromuscular transmission failure.
Why it matters
Electrophysiological changes from long-term cosmetic botulinum toxin use can mimic intrinsic neuromuscular disorders, highlighting the need for clinical neurophysiologists to screen for aesthetic procedure history during diagnostic workups.
Limits
The abstract describes a narrative review and presents no original patient data, predefined systematic search criteria, or pooled effect estimates. Quantitative incidence rates for atrophy, spread, or permanent denervation are not provided.
Cited by
- supports Long-term use of Botox induces sarcopenia in facial muscles by intentionally breaking down the neuromuscular junction and atrophying the nerves.