Botulinum Toxin for Superior Third of the Face

Abstract

The history of botulinum toxin dates back to 1817 when it was described by Justinus Kerner, who associated the deaths by intoxication from a poison encountered in smoked sausages with alterations in the excitability of the motor and autonomic nervous system (Dressler et al. Arq Neuropsiquiatr 63:180–185, 2005). In 1895, Emile Van Ermengem discovered the bacterial agent and its mechanism of action. In 1978, Alan Scot performed the first tests with botulinum toxin A injected in human beings for the treatment of strabismus, and later, its use was described for the treatment of segmental dystonias, tremors, and other abnormal movements (Silberstein, Pain Pract 4:S19–26, 2004). It was subsequent to the observation of improvement in wrinkles in patients treated for blepharospasm that the Canadian couple Jean and Alastair Carruthers described the cosmetic use of the toxin in 1987 (Wenzel, Am J Heath-Syst Pharm 61:s5–10, 2004, Setler, Clin J Pain 18:s119–124, 2002, Unno et al. Rev Bras Anestesiol 55:250–255, 2005).