Complications in aesthetic medicine can be considered a consequence of the inexperience of the performing physician, but in some cases, they can unveil far more serious conditions, hitherto silent. We present a case of a 48-year-old patient who, following botulinum toxin type A (Botox) injection for treatment of forehead wrinkles, returned to our attention 12 days later for a discrete, newly onset right eyelid ptosis. This ptosis was a telltale sign of the presence of an intracranial aneurysm closely related with the oculomotor nerve. The lack of compensatory action by the frontalis muscle in maintaining the eyelid in position allowed us to highlight the extrinsic compression deficit of the oculomotor nerve. Subsequently, the patient underwent endovascular treatment of the aneurysm, leading to complete resolution of the case.
Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.