These do not differ from side-effects after other types of injections. Sequelae that can occur at any site after a botulinum toxin injection include pain, edema, erythema, ecchymosis, and short-term hypesthesia. Treatment with botulinum toxin is widely viewed as safe, effective and largely devoid of serious side effects. At present, there are three BoNT-A products available worldwide: abobotulinumtoxinA (Dysport), onabotulinumtoxinA (Botox), and incobotulinumtoxinA (Xeomin). Type A (BoNT-A) is the most potent and it is used the most commonly. There are multiple serotypes of botulinum toxins A-G varying with the molecular size, biosynthesis and cell mechanisms. The action of botulinum toxins is a result of their potent ability to inhibit neurotransmitter release. Dynamic wrinkles are the main cosmetic indications for the use of botulinum toxin. It is also the most common cosmetic procedure performed world-wide, with estimates of nearly 3 million injections per year. Injections with botulinum toxin are effective for many clinical disorders that involve involuntary muscle activity or increased muscle tone. Botulinum toxins are among the most toxic poisons, with a wide spectrum of both therapeutic and cosmetic indications for use.
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