Advanced Cosmetic Use of Botulinum Toxin Type A
When the cosmetic use of botulinum toxin type A (BTX-A) was ﬁrst introduced in the early 1990s, it was a novel, almost shocking concept; now, however, the cosmetic application of BTX-A is commonly recognized as the gold standard in upper facial rejuvenation. The huge expansion in the acceptance of its use-and the regulatory approval of BTX-A (BOTOX, BOTOX Cosmetic, Allergan Inc., Irvine, California, U.S.), for the treatment of the glabella area, in Canada and the United Stateshas led to a much wider, more scientiﬁcally based clinical experience. This chapter will focus primarily on improved uses and advanced cosmetic applications of BTX-A, speciﬁcally the BOTOX and BOTOX Cosmetic formulations, unless otherwise indicated, since it is with this product that we have had the most experience. It is important to emphasize that before using any product for an indication, physicians should consult the literature available on that speciﬁc formulation.