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.

In 1980, Alan B Scott published the use of botulinum neurotoxin type A by injection into extraocular muscles for treatment of strabismus. Use in blepharospasm was published in 1985, and cervical dystonia in 1986, followed by hemifacial spasm and other dystonias, including spasmodic dysphonia, hand dystonia, and conditions such as limb spasticity.

Formulations of neurotoxin type A worldwide include: Botox/onabotulinumtoxinA, Dysport/abobotulinumtoxinA, Xeomin/incobotulinumtoxinA, and a Chinese product marketed under various brand names in Asia. Botulinum neurotoxin type B is marketed as Neurobloc/Myobloc, or rimabotulinumtoxinB. PrabotulinumtoxinA and daxibotuinumtoxinA-Ianm are type A toxins under development.

Plantar fasciitis (PF) is the most common cause of chronic heel pain, predominantly impacting those who perform heavy footwork, are avid runners or lare ong-distance walkers. Overuse injury leads to repetitive microtears of the plantar fascia near the calcaneus, irritating pain fibers and producing secondary inflammation. Patients typically have intense heel pain, described as aching, jabbing or burning. Pain usually starts with the first few steps in the morning and is reproduced by palpation of the median tubercle of the calcaneum and with dorsiflexion of the toes.

Conventional treatments such as ice, heel cup orthoses, deep-tissue massage and night splints, periods of immobilization and stretching/strengthening exercise programs can reduce pain satisfactorily. Persistent discomfort may respond to treatments such as ultrasound, iontophoresis and phonophoresis. More severe and recalcitrant cases require extracorporeal shock wave therapy (ECSWT) or local corticosteroid injections. When medical approaches fail, surgery is advocated but can only offer modest results.

This chapter reviews pertinent studies to date on the application of botulinum neurotoxin to plantar fasciitis, and discusses injection technique and dosing, including the WRAMC–Yale technique for injecting the soleus muscle, along with the plantar fascia. Clear anatomical illustrations are provided.

Following Marilyn Strathern, social anthropologists have interrogated the “awkward relationship” between anthropology and feminism. This chapter revisits the awkwardness of British social anthropology by looking at its problematic relationship not only with feminism but also with anthropology “at home” and with ethical or moral judgments. Its focus is on cosmetic surgery and other quasi-medical cosmetic procedures such as the use of botulinum toxins (e.g., Botox) and dermal fillers. The chapter discusses the tension between anthropological and feminist approaches, revealed when the anthropologist is tasked with taking an ethical stance. It draws on the experience of the anthropologist having, in their early career, to defend anthropology “at home” and, in their late career, chairing a bioethical committee on the ethics of cosmetic procedures, and concludes that there are times when anthropology and feminism best serve each other by maintaining a mutually critical relation: by continuing to trouble each other.