The role of neurotoxins in the periorbital and midfacial areas

Abstract

Initially popularized for the treatment of strabismus and blepharospasm, injection of botulinum neurotoxin has become the most commonly performed cosmetic treatment in the United States. Injection techniques have been particularly well-studied in the midface and periocular region, and patient satisfaction tends to be very high. We review the salient differences among available neurotoxins, how to optimally reconstitute them, how to inject the forehead, glabella, lateral canthal lines ("crow's feet"), infralid region, and transverse nasal lines ("bunny lines"), how to sculpt the brow, and how to manage potential complications.

Keywords: AbobotulinumtoxinA; Botulinum toxin; Facial rhytids; IncobotulinumtoxinA; Neurotoxin; OnabotulinumtoxinA; RimabotulinumtoxinB.