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15 - Cosmetic uses of botulinum toxin A

Published online by Cambridge University Press:  02 December 2009

By
Kenneth Beer ,
Joel L. Cohen  and
Alastair Carruthers
Edited by
Anthony B. Ward  and
Michael P. Barnes
Kenneth Beer
Affiliation:
Palm Beach Esthetic Center, West Palm Beach, Florida, USA
Joel L. Cohen
Affiliation:
AboutSkin Dermatology and Dermsurgery, Englewood, Colorado, USA
Alastair Carruthers
Affiliation:
Department of Dermatology, University of British Columbia, Vancouver BC, Canada
Anthony B. Ward
Affiliation:
University Hospital of North Staffordshire
Michael P. Barnes
Affiliation:
Hunters Moor Regional Neurological Rehabilitation Centre
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Summary

Introduction

The cosmetic uses of botulinum toxin (BoNT) are the most commonly used of its applications. Interest started after the effect of BoNT was shown in the treatment of blepharospasm and the first description of botulinum toxin for treatment of glabellar frown lines was in 1992. At that time, the use of this potent neurotoxin for cosmetic indications was an interesting footnote to treatments for strabismus, torticollis and other dystonias. Subsequently, physicians began to study and use the botulinum toxins for a variety of cosmetic indications. Today, BoNT is the most commonly performed cosmetic procedure in the world. Understanding how these toxins are used in this arena is essential to any discussion of the botulinum toxins.

Dilution of the toxin for cosmetic purposes

For the purposes of this chapter, the dilution of BoNT will be described in units of the BOTOX® brand of type A toxin. Oculoplastic specialists usually inject using a 1 ml dilution per 100 units of BOTOX®, whereas dermatologists and plastic surgeons vary in their practice towards a general range from 1 ml to 4 ml per 100 units. Variations in concentration affect the concentration gradient between the toxin and its environment. In the forehead, for instance, a dilute concentration may be preferable in order to increase migration, but, in general, clinicians use lower volumes to minimize the risk of this getting into unplanned areas.

Type
Chapter
Information
Clinical Uses of Botulinum Toxins , pp. 328 - 348
Publisher: Cambridge University Press
Print publication year: 2007

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References

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