We report the case of a 24-year-old woman who was referred to one of the authors\' clinics after six days of botulinum toxin type A injection to treat dynamic lines on her forehead, glabella complex, and crow\'s feet area. Her first esthetic injection was done by another colleague elsewhere in a different clinic. Her main complaint was full eyelid ptosis, which started four days after her treatment and continued to aggravate until the time she sought our help. We treated it with another dose of botulinum toxins. The patient started to notice a gradual improvement in her eyelid five days after our injection, so on day 14th, her eyelid was very closely back to normal opening; complete recovery was achieved. Ptosis due to botulinum toxin injection was surprisingly and successfully reversed in our article by a second dose of botulinum toxins. This suggests that this management successfully treats such cases and can deliver a beneficial reversal option for practitioners and their patients. The case report concludes that ptosis should be promptly evaluated and treated through a multimodal approach.

When a clinician, especially one who is specialized in primary care is faced with presenting complaints of deep, sharp, anterior chest pain, the most common differential diagnoses include cardiac and gastrointestinal pain. Musculoskeletal pain is thought of less frequently as a possible root cause. In this case report, we describe the clinical journey of a female athlete who presented with complaints of burning anterior chest pain. Her sternalis syndrome pain was first misdiagnosed as pain of cardiac origin, resulting in pacemaker placement into the patient\'s chest. The pain continued, and the same musculoskeletal pain was then presumed to be of gastrointestinal origin due to a previous history of gastroesophageal reflux disease (GERD). As a result of this misidentification, the patient underwent an unnecessary esophageal surgical procedure. Here, we identify the origins of sternalis syndrome pain, what other conditions the pain may be confused with, and how clinicians should not be quick to exclude musculoskeletal pain from a differential diagnosis of acute chest pain. We discuss effective treatments for sternalis syndrome and shed light on this less common cause of anterior chest pain to promote more accurate diagnosis and avoidance of unnecessary surgical interventions.

Seat belt syndrome (SBS) represents all injury profiles associated with seat belt injuries and motor vehicle crashes (MVCs). Seat belt syndrome classically presents with a superficial seat belt sign that may signify deeper intra-abdominal and/or spinal involvement. The amount of force transmitted from the restraint to the passenger ultimately dictates the amount and severity of the injury. We present a unique case of a 59-year-old female involved in a motor vehicle crash with multiple traumatic injuries, including seat belt syndrome, abdominal wall transection, and bowel injuries. She later had reconstruction of her traumatic abdominal wall hernias (TAWHs). Three unique approaches were used in the management of her traumatic abdominal wall hernias: (1) preoperative Botulinum toxin (Botox) injections, (2) operative use of biologic and bioabsorbable meshes in contaminated fields, and (3) postoperative physical therapy and body positioning. The patient did not experience any recurrence of these hernias after her abdominal wall reconstruction and remains alive at the time this case was written. The diagnostic criteria and surgical management of traumatic abdominal wall hernias have yet to be established, and the case presented here provides approaches that should serve as future areas for study.