My Personal Experience with Botulinum Toxin

  • Mary SheuEmail author
Living reference work entry

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Part of the Clinical Approaches and Procedures in Cosmetic Dermatology book series (CAPCD)


Facial rejuvenation and enhancement with neurotoxin injections can produce results that can appear dramatic as well as natural. A thorough knowledge of facial anatomy in repose and with animation is critical for optimal outcomes. Communicating with patients regarding the agreed-upon goals, realistic expectations and limitations of this therapy is important for patient satisfaction. The purpose of this chapter is to provide clinical pearls to optimize results for the cosmetic use of botulinum toxin in the face and neck. We will also review practical considerations such as reconstitution, injection technique and pre- and postprocedure patient education.


Botulinum toxin Neurotoxin Neuromodulator Injection technique Glabella Brow lift Practical tips Reconstitution Dilution Combination therapies 


  1. Benedetto AV, Lahti JG. Measurement of the anatomic position of the corrugator supercilii. Dermatol Surg. 2005;31(8 Pt 1):923–7.CrossRefGoogle Scholar
  2. Carruthers A, Carruthers J. Eyebrow height after botulinum toxin type A to the glabella. Dermatol Surg. 2007;33(1):S26–31.CrossRefGoogle Scholar
  3. Carruthers A, Carruthers J, Monheit GD, Davis PG, Tardie G. Multicenter, randomized, parallel-group study of the safety and effectiveness of onabotulinumtoxinA and hyaluronic acid dermal fillers (24-mg/ml smooth, cohesive gel) alone and in combination for lower facial rejuvenation. Dermatol Surg. 2010;36(Suppl 4):2121–34.CrossRefGoogle Scholar
  4. Cosmetic Plastic Surgery Statistics Report. American Society of Plastic Surgeons. Accessed 12 Oct 2015.
  5. de Almeida AR, da Costa Marques ER, Banegas R, Kadunc BV. Glabellar contraction patterns: a tool to optimize botulinum toxin treatment. Dermatol Surg. 2012;38(9):1506–15.CrossRefGoogle Scholar
  6. ISAPS. International Survey on Aesthetic/Cosmetic Procedures Performed in 2014. International Society of Aesthetic Plastic Surgery. Accessed 30 Jan 2016.
  7. Kim HS, Kim C, Cho H, Hwang JY, Kim YS. A study on glabellar wrinkle patterns in Koreans. J Eur Acad Dermatol Venereol. 2014;28(10):1332–9.CrossRefGoogle Scholar
  8. Macdonald MR, Spiegel JH, Raven RB, Kabaker SS, Maas CS. An anatomical approach to glabellar rhytids. Arch Otolaryngol Head Neck Surg. 1998;124(12):1315–20.CrossRefGoogle Scholar
  9. West TB, Alster TS. Effect of botulinum toxin type A on movement-associated rhytides following CO2 laser resurfacing. Dermatol Surg. 1999;25(4):259–61.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Johns Hopkins School of MedicineBaltimoreUSA

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