ABSTRACT
Besides a medical degree, a well-structured training program that assesses both the theoretical and practical skills of the practitioner is a prerequisite for the botulinum toxin injector. The Dutch authorities have officially approved this training program as it is structured according to the CAN-MEDS system and therefore meets the highest standards of medical specialist training. The speed of diffusion of botulinum toxin is dependent on molecule size, and will stop after binding to its target receptor. Several publications have shown differences in diffusion radii of botulinum toxin products; in particular, differences between the products of Ipsen and Allergan have been widely described. Ipsen appears to have a larger diffusion radius than the Allergan botulinum toxin. Spread of botulinum toxin is a clinical observation that differs from diffusion. Attention should be paid to potential malignant lesions and other skin pathologies that are contra indications for injection.
