Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-wg55d Total loading time: 0 Render date: 2024-04-30T18:35:49.733Z Has data issue: false hasContentIssue false

Chapter 21 - Cosmetic uses of botulinum neurotoxins

Published online by Cambridge University Press:  05 February 2014

By
Joshua Spanogle ,
Dee Anna Glaser  and
Christopher Zachary
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett  and
Christopher Zachary
Joshua Spanogle
Affiliation:
Department of Dermatology, University of California, Irvine, Irvine, CA, USA
Dee Anna Glaser
Affiliation:
Department of Dermatology, Saint Louis University School of Medicine, St. Louis, MO, USA
Christopher Zachary
Affiliation:
Department of Dermatology, University of California, Irvine
Daniel Truong
Affiliation:
The Parkinson’s and Movement Disorders Institute, Fountain Valley, California
Dirk Dressler
Affiliation:
Department of Neurology, Hannover University Medical School
Mark Hallett
Affiliation:
George Washington University School of Medicine and Health Sciences, Washington, DC
Christopher Zachary
Affiliation:
Department of Dermatology, University of California, Irvine
Get access

Summary

The injection of botulinum neurotoxin (BoNT) for cosmetic purposes is the most commonly performed cosmetic procedure in the USA, with 4 million such procedures performed in 2011 alone (American Society for Aesthetic Plastic Surgery, 2011).

With time, overlying skin loses both its elasticity and thickness. This, coupled with repeated pleating and contraction of the skin over many years, will result in wrinkles. Cosmetically, the primary function of BoNT is to paralyze the muscles of facial expression. By relaxing the relevant underlying muscles of facial expression, BoNT will eliminate the so-called “dynamic” rhytids (wrinkles). Over time, even the appearance of static rhytids may be improved. In a 2007 study, patients reported looking 3 years’ younger than baseline 4 weeks after receiving BoNT to the upper face (Carruthers and Carruthers, 2007)

Currently (2012), there are three BoNT type A (BoNT-A) formulations with a cosmetic indication available in the USA: onabotulinumtoxinA (Botox, Allergan. Irvine, CA, USA), abobotulinumtoxinA (Dysport, Ipsen, Slough, UK) and incobotulinumtoxinA (Xeomin, Merz, Frankfurt/M, Germany). All are approved for the treatment of glabellar lines.

Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 181 - 193
Publisher: Cambridge University Press
Print publication year: 2014

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alam, M, Dover, J, Arndl, K (2002). Pain associated with injection of botulinum A exotoxin reconstituted using isotonic sodium chloride with and without preservative. Arch Dermatol, 138, 510–14.CrossRefGoogle ScholarPubMed
American Society for Aesthetic Plastic Surgery (2011). Cosmetic Surgery National Data Bank. 2011. New York: American Society for Aesthetic Plastic Surgery (, accessed 17 May 2013).Google Scholar
Carruthers, J, Carruthers, A (2003). Using Botulinum Toxins Cosmetically. London: Martin Dunitz, pp. 17–32.CrossRefGoogle Scholar
Carruthers, J, Carruthers, A (2007). Botulinum toxin type A treatment of multiple upper facial sites: patient-reported outcomes. Dermatol Surg, 33(Suppl 1), S10–17.CrossRefGoogle ScholarPubMed
Choe, SW, Cho, WI, Lee, CK, Seo, SJ (2005). Effects of botulinum toxin type A on contouring of the lower face. Dermatol Surg, 31, 502–7; discussion 507–8.CrossRefGoogle ScholarPubMed
Cliff, SH, Judodihardjo, H, Eltringham, E (2008). Different formulations of botulinum toxin type A have different migration characteristics: a double-blind, randomized study. J Cosmet Dermatol, 7, 50–4.CrossRefGoogle ScholarPubMed
Gaofeng, L, Jun, T, Bo, P et al. (2010). Evaluation and selecting indications for the treatment of improving facial morphology by masseteric injection of botulinum toxin type A. J Plast Reconstr Aesthet Surg, 63, 2026–31.CrossRefGoogle ScholarPubMed
Gassia, V, Beylot, C, Bechaux, S, Michaud, T (2009). Botulinum toxin injection techniques in the lower third and middle of the face, the neck and the decollete: the “Nefertiti lift”. Ann Dermatol Venereol, 136(Suppl 4), S111–18.CrossRefGoogle ScholarPubMed
Jost, WH, Kohl, A, Brinkmann, S, Comes, G (2005). Efficacy and tolerability of a botulinum toxin type A free of complexing proteins (NT 201) compared with commercially available botulinum toxin type A (BOTOX) in healthy volunteers. J Neural Transm, 112, 905–13.CrossRefGoogle Scholar
Jost, WH, Blümel, J, Grafe, S (2007). Botulinum neurotoxin type A free of complexing proteins (XEOMIN®) in focal dystonia. Drugs. 67, 669–83.CrossRefGoogle Scholar
Levy, PM (2007). The “Nefertiti lift”: a new technique for specific re-contouring of the jawline. J Cosmet Laser Ther, 9, 249–52.CrossRefGoogle Scholar
Oliveira de Morais, O, Matos Reis-Filho, E, Vilela Pereira, L, Martins Gomes, C, Alves, G (2012). Comparison of four botulinum neurotoxin type a preparations in the treatment of hyperdynamic forehead lines in men: a pilot study. J Drugs Dermatol, 11, 216–19.Google ScholarPubMed
Park, MY, Aim, KY, Jung, DS (2003). Botulinum toxin type A treatment for contouring the lower face. Dermatol Surg, 29, 477–83.Google ScholarPubMed
Rzany, BD, Dill-Muller, D, Grablowitz, DHeckmann, M, Daird, D (2007). Repeated botulinum toxin A injections for the treatment of lines in the upper face: a retrospective study of 4103 treatments in 945 patients. Dermatol Surg, 33(Suppl 1), S18–25.CrossRefGoogle ScholarPubMed
Talarico-Filho, S, Nascimento, MM, De Macedo, FS, De Sanctis Pecora, C (2007). A double-blind, randomized, comparative study of two type A botulinum toxins in the treatment of primary axillary hyperhidrosis. Dermatol Surg, 33(Suppl 1), S44–50.CrossRefGoogle ScholarPubMed
To, EW, Ahuja, AT, Ho, WS, et al. (2001). A prospective study of the effect of botulinum toxin A on masseteric muscle hypertrophy with ultrasonographic and electromyographic measurement. Br J Plast Surg, 54, 197–200.CrossRefGoogle ScholarPubMed
Wohlfarth, K, Schwandt, I, Wegner, F et al. (2008). Biological activity of two botulinum toxin type A complexes (Dysport and Botox) in volunteers: a double-blind, randomized, dose-ranging study. J Neurol, 255, 1932–9.CrossRefGoogle ScholarPubMed
Wollina, U, Konrad, H (2005). Managing adverse events associated with botulinum toxin type A: a focus on cosmetic procedures. Am J Clin Dermatol, 6, 141–50.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×