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Chapter 22 - Cosmetic Uses of Botulinum Neurotoxins for the Upper Face
- By Katherine Glaser, Dee Anna Glaser
Edited by Daniel Truong, University of California, Riverside, Dirk Dressler, Hannover Medical School, Mark Hallett, National Institutes of Health (NIH), Christopher Zachary, University of California, Irvine, Mayank Pathak, Truong Neuroscience Institute
Book:

Manual of Botulinum Toxin Therapy

Published online:

02 November 2023

Print publication:

23 November 2023, pp 188-196
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Summary

Botulinum neurotoxin (BoNT) injections are the most commonly performed cosmetic procedure in the USA. Rhytids, commonly known as wrinkles, develop over time from repeated pleating and contraction of underlying skeletal muscle along with decreased elasticity and thickness of the overlying skin. Typically, rhytids appear perpendicular to the direction of muscular contraction.
BoNT prevents skeletal muscle contraction by inhibiting acetylcholine release from the neuromuscular junction, thereby relaxing the relevant muscles. BoNT can soften the appearance of rhytids and reduce further formation. This chapter discusses the use of BoNT specifically for the treatment of rhytids of the upper face including the glabella, forehead, peri-ocular region and nose. Many of these treatments are considered off-label but are known to be safe and effective.