Case study: providing Botox treatment for a patient with pre-existing conditions

The patient, a 36-year-old female patient, was diagnosed with neurofibromatosis type 2. She also developed a benign tumour that affected her hearing nerves. The patient had the tumour removed and received therapy, which resulted in some deafness and paralysis of the facial muscles on the left side of her face. She uses a cochlear implant and lip reads to communicate.

Her presenting complaint to me came originally in March 2022, when I first launched CJS Holistic Aesthetics in the southeast of England. I was advertising my new medical aesthetics clinic on social media and the patient contacted me to enquire about the treatments I was offering. She had had unsuccessful facial physiotherapy to rectify her uneven expressions and had read about botulinum toxin as a possible treatment. Nonetheless, her needle phobia posed an even bigger challenge to manage alongside an already complex case.

In all honesty, I was very hesitant to treat the patient at first, as even my highly experienced colleagues in aesthetics had advised me that they would steer clear from such a challenging case. However, I truly wished to help this patient regain her confidence, and I also worried she may end up seeking treatment from someone that could not provide her with appropriate treatment under the best model of care.