Comparisons among botulinum toxins: an evidence-based review.

Background: Botulinum neurotoxin treatment is the most common aesthetic procedure in the United States. A number of serotypes and formulations are available worldwide. Similarities and differences among these toxins were evaluated by reviewing the existing literature.

Hyaluronic acid fillers and botulinum toxin type a: rationale for their individual and combined use for injectable facial rejuvenation.

Soft-tissue augmentation has seen a renaissance of interest, as an increasing number of patients seek aesthetic improvement without major downtime. Although injectable agents for soft-tissue augmentation have been widely available for more than 20 years, the renewed interest has been fueled in part by the introduction of botulinum toxin type A. The unequivocal establishment of predictable and aesthetic results, initially and primarily in the upper face, created a need for an agent that would work equally well in the lower face and that could be administered in an office setting.

A brief overview and history of temporary fillers: evolution, advantages, and limitations.

Facial soft-tissue augmentation by injection has become increasingly popular as a minimally invasive option for patients seeking cosmetic facial enhancement. Surgical rejuvenation procedures of the face often relate to a less than comprehensive solution to many of the changes that occur with age. Indeed, the surgical "lift," while providing the opportunity for soft-tissue repositioning, often fails to provide volumetric restoration to the face that is lost with aging.

Soft tissue augmentation 2006: filler fantasy.

As an increasing number of patients seek esthetic improvement through minimally invasive procedures, interest in soft tissue augmentation and filling agents is at an all-time high. One reason for this interest is the availability of botulinum toxin type A, which works superbly in the upper face. The rejuvenation of the upper face has created much interest in injectable filling agents and implant techniques that work equally well in the restoration of the lower face.

Techniques for soft tissue augmentation: an 'a to z'.

As society continues to seek the most opportune means to preserve youthful looks, an interest in filling substances has been reawakened. This is partly because the upper third of the face can now be successfully treated as a result of the development and recent US FDA approval of botulinum toxin (Botox). Patients seeking cosmetic improvement need no longer resort to invasive procedures that require down-time for the upper third of the face, and they are consequently seeking similar results for the lower two-thirds of the face.

A quality rating scale for aesthetic surgical procedures.

Background: Cosmetic dermatologic procedures offer the promise of visible aesthetic enhancement with minimal risk. While in recent years the number of available procedures has proliferated, there are few objective methods for evaluating the relative quality of these procedures for particular indications or specific patients.

Objective: (A) To develop a simple, easy-to-use numerical rating scale to assess the quality of cosmetic surgical procedures on a range of parameters pertaining to clinical efficacy and patient satisfaction; (B) to statistically validate the discriminative value of this rating scale.

Safety and efficacy of nonanimal stabilized hyaluronic acid for improvement of mouth corners.

Background: Esthetic concern with downturned mouth corners ("mouth frown") is increasing in the aging baby-boomer generation. A new technique to offer structural support using the recently approved filler nonanimal stabilized hyaluronic acid (NASHA; Restylane, Q-med Inc., Uppsala, Sweden) is described.

Complications with the use of botulinum toxin.

This article discusses complications with the use of botulinum toxin. The following topics are explored: conditions caused by muscle spasms, resistance to botulinum toxin, cosmetic use of botulinum toxin, complications in treating hyperhidrosis, treatment of migraine headaches, and informed consent.

Botox for the eyes and eyebrows.

The forehead and crow's-feet (periorbital wrinkles) are among areas where Botox has been quite helpful. This cosmetic use is not approved by the Food and Drug Administration and is considered off-label. The effect, although temporary, is extremely popular with patients, has a very low incidence of side effects, and is a relatively easy technique to acquire.

Contraindications and complications with the use of botulinum toxin.

Cosmetic use of BTX has skyrocketed in recent years, especially since the approval of BTX-A for treatment of glabellar lines. Complications and adverse reactions can easily arise, particularly for the novice injector. This paper provides insights from an experienced physician on how to avoid these complications, and how to treat them when and if they occur.

The therapeutic potential of botulinum toxin.

Background: Botulinum toxin type A (BTX-A; commercial preparation BOTOX) is most well known for its effect on muscle contraction because of the BTX binding to the presynaptic nerve terminal, inhibiting the release of acetylcholine (ACH). The therapeutic benefit of BTX-A, however, can also be isolated to pain relief alone, suggesting that BTX-A also works through additional modes of action.

Objective: This article provides insight by an experienced physician into four different case reports.