Friday Pop Quiz #258

The correct answer is B. Formation of festoon.

The image shows findings of festooning following botulinum toxin injection in this patient. Prior blepharoplasty may lead to weakening of the orbicularis oculi muscle, predisposing this patient to festooning.

The other causes are not correct in this patient with festoon formation. Treatment may include skin-muscle flap, midface lift, or direct excision.


Goldman MP. Festoon formation after infraorbital botulinum A toxin: a case report. Dermatol Surg. 2003;29(5):560-561. doi:10.1046/j.1524-4725.2003.29130.x