Botulinum toxin A (BoNT-A) injections are a popular non-surgical procedure for facial rejuvenation with increasingly pervasive use.

The increase in popularity and use is met with limited regulations potentially posing a significant risk to patient safety and public health.

This study aims to assess the safety profile of cosmetic glabellar and forehead BoNT-A injections and further evaluates BoNT-A type on the complication rate.

A systematic search of MEDLINE and EMBASE was performed for studies reporting complications after cosmetic BoNT-A injections glabellar or in the forehead region.

A random effects meta-analysis was carried out to assess complication rate. Where there were sufficient Randomized-Controlled Trials (RCTs) a network meta-analysis was performed.