Potential Foreign Body Emboli Associated with Botulinum Toxin A Injections

Although the injection of Botox Cosmetic for the treatment of dynamic rhytids is safe and effective, there is a potential risk for foreign body embolization. This case report documents the presence of a rubber particle in the reconstituted Botox product. Although the risk of embolization is thought to be very small because it is unlikely that the particle could be injected through most needle orifices, this risk can be eliminated through the use of No Kor needles. Alternatively, alteration of the manufacturing process for the bottle cap may reduce the risk of coring a piece of the cap during reconstitution. Injectors should be aware of this risk and visually inspect Botox prior to injection.