Botulinum toxin in facial plastic surgery

Abstract

Since the U.S. Food and Drug Administration approved botulinum toxin (BoNT) type A in 2002 for glabellar rhytids, BoNT has been used successfully for many clinical indications in facial plastic surgery. The current usage of BoNT as a non-invasive procedure for rhytids of the aging face include but are not limited to rhytids of the forehead, glabella, lateral orbit, nasal sidewall, upper lip, vertical perioral rhytids, melomental fold, and chin. In addition to facial rhytids, BoNT has been shown to be effective for a variety of other clinical indications in facial plastic surgery, including masseter hypertrophy, facial paralysis, brow ptosis, and wound healing. This article will review the pharmacology and mechanism of action of BoNT. In addition, the suggested dosage and instruction for injection for facial rhytids will be discussed along with BoNT usage for clinical indications other than rhytids.

Keywords

Botulinum toxin / botox / neurotoxin

References

[1] Clark RP.Botulinum toxin: a treatment for facial asymmetry caused by facial nerve paralysis..Plast Reconstr Surg1989;84:353-5

[2] Carruthers JD.Treatment of glabellar frown lines with C. botulinum-A exotoxin..J Dermatol Surg Oncol1992;18:17-21

[3] Ong AA.Neurotoxins..Facial Plast Surg2019;35:230-8

[4] American Society of Plastic Surgeons News Release. Plastic Surgery Statistics Report. Available from: https://www.plasticsurgery.org/news/plastic-surgery-statistics. [Last accessed on 10 Nov 2020]

[5] Berwick S.Older women’s negative psychological and physical experiences with injectable cosmetic treatments to the face..J Women Aging2017;29:51-62

[6] Huang W,Rogachefsky AS.Pharmacology of botulinum toxin..J Am Acad Dermatol2000;43:249-59

[7] Jankovic J.Therapeutic uses of botulinum toxin..N Engl J Med1991;324:1186-94

[8] Hexsel D,do Prado DZ.Field effect of two commercial preparations of botulinum toxin type A: a prospective, double-blind, randomized clinical trial..J Am Acad Dermatol2012;67:226-32

[9] Hexsel D,Porto MD,Schilling-Souza J.Fields of muscular and anhidrotic effects of 2 botulinum toxin-A commercial preparations: a prospective, double-blind, randomized, multicenter study..Dermatol Surg.2015;41 Suppl 1:S110-8

[10] Cohn JE.Advanced techniques for the use of Neurotoxins in non-surgical facial rejuvenation..Aesthetic Plast Surg2020;44:1788-99

[11] Rohrich RJ,Crosby MA.The role of hyaluronic acid fillers (Restylane) in facial cosmetic surgery: review and technical considerations..Plast Reconstr Surg2007;120:41S-54

[12] Carruthers JD,Menter MA,Eadie N.Double-blind, placebo-controlled study of the safety and efficacy of botulinum toxin type A for patients with glabellar lines..Plast Reconstr Surg2003;112:1089-98

[13] Beer JI,Scheuer JF3rd.Three-dimensional facial anatomy: structure and function as it relates to injectable neuromodulators and soft tissue fillers..Plast Reconstr Surg Glob Open2016;4:e1175 PMCID:PMC5172484

[14] Scheinfeld N.The use of apraclonidine eyedrops to treat ptosis after the administration of botulinum toxin to the upper face..Dermatol Online J2005;11:9

[15] Fabi SG,Guiha I.A two-center, open-label, randomized, split-face study to assess the efficacy and safety of one versus three intradermal injection sites of abobotulinumtoxinA in the treatment of lateral periocular rhytides..J Drugs Dermatol2013;12:932-7

[16] Carruthers J.Aesthetic botulinum A toxin in the mid and lower face and neck..Dermatol Surg2003;29:468-76

[17] Loos BM.Relevant anatomy for botulinum toxin facial rejuvenation..Facial Plast Surg Clin North Am2003;11:439-43

[18] Suber JS,Prince MD.OnabotulinumtoxinA for the treatment of a “gummy smile”..Aesthet Surg J2014;34:432-7

[19] Sucupira E.A simplified method for smile enhancement: botulinum toxin injection for gummy smile..Plast Reconstr Surg2012;130:726-8

[20] Choi YJ,Gil YC.Anatomical considerations regarding the location and boundary of the depressor anguli oris muscle with reference to botulinum toxin injection..Plast Reconstr Surg2014;134:917-21

[21] Kim NH,Park JB.Botulinum toxin type A for the treatment of hypertrophy of the masseter muscle..Plast Reconstr Surg2010;125:1693-705

[22] Matarasso A.Botulinum A exotoxin for the management of platysma bands..Plast Reconstr Surg2003;112:138S-40

[23] Filipo R,Covelli E,Bertoli GA.Botulinum toxin in the treatment of facial synkinesis and hyperkinesis..Laryngoscope2012;122:266-70

[24] King M.Management of Ptosis..J Clin Aesthet Dermatol2016;9:E1-4 PMCID:PMC5300727

[25] Olson JJ.Balanced botox chemodenervation of the upper face: symmetry in motion..Semin Plast Surg2007;21:47-53 PMCID:PMC2884826

[26] Gassner HG,Otley CC.Botulinum toxin to improve facial wound healing: A prospective, blinded, placebo-controlled study..Mayo Clin Proc2006;81:1023-8

[27] Li J,Kirsner R.Pathophysiology of acute wound healing..Clin Dermatol2007;25:9-18

[28] Ghazawi FM,Gilardino MS,Jafarian F.Insights into the pathophysiology of hypertrophic scars and keloids: How do they differ?.Adv Skin Wound Care2018;31:582-95

[29] Kasyanju Carrero LM,Liu HF,Zhou BR.Botulinum toxin type A for the treatment and prevention of hypertrophic scars and keloids: updated review..J Cosmet Dermatol2019;18:10-5

[30] Xiao Z.Effects of botulinum toxin type a on collagen deposition in hypertrophic scars..Molecules2012;17:2169-77 PMCID:PMC6268678

[31] Austin E,Jagdeo J.The cellular response of keloids and hypertrophic scars to Botulinum toxin A: a comprehensive literature review..Dermatol Surg2018;44:149-57

[32] Small R.Botulinum toxin injection for facial wrinkles..Am Fam Physician2014;90:168-75

[33] Batniji RK.Update on botulinum toxin use in facial plastic and head and neck surgery..Curr Opin Otolaryngol Head Neck Surg2004;12:317-22

[34] Naumann M,Carruthers J.Meta-analysis of neutralizing antibody conversion with onabotulinumtoxinA (BOTOX®) across multiple indications..Mov Disord2010;25:2211-8