Access Dermatology

Introduction

Successful treatment with botulinum toxin (BTX) requires a thorough understanding of facial anatomy, proper injection technique and dosing. Treatment of selected facial muscles with BTX has become an integral component in the rejuvenation armamentarium. One of the first clinical applications of BTX was in the treatment of blepharospasm (1, 2). The subsequent use of BTX in the cosmetic arena was sparked by Drs. Jean and Alastair Carruthers' observation in 1987 that glabellar frown line appearance was improved in patients treated with BTX for blepharospasm. Further study of the cosmetic applications of BTX resulted in a landmark paper describing its use in the treatment of glabellar lines (3). Since that time, there has been a meteoric rise in the use of BTX, and it is currently the most commonly performed nonsurgical aesthetic procedure (4).