Cosmetic uses of botulinum toxin A

doi:10.1017/CBO9780511544842.015

15 - Cosmetic uses of botulinum toxin A

Published online by Cambridge University Press: 02 December 2009

Kenneth Beer ,

Joel L. Cohen and

Alastair Carruthers

Edited by

Anthony B. Ward and

Michael P. Barnes

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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.

Information

Type: Chapter
Information: Clinical Uses of Botulinum Toxins , pp. 328 - 348

DOI: https://doi.org/10.1017/CBO9780511544842.015 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2007

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References

Carruthers, J. D. and Carruthers, J. A. (1992). Treatment of glabellar frown lines with Clostridium botulinum-A exotoxin. Journal of Dermatologic Surgery and Oncology, 18(1), 17–21.CrossRef Google Scholar

Hsu, T. S., Dover, J. S. and Arndt, K. A. (2004). Effect of volume and concentration on the diffusion of botulinum exotoxin A. Archives of Dermatology, 140(11), 1351–4.CrossRef Google Scholar PubMed

Dover, J. S. and Arndt, K. A. (2002). Pain associated with injection of botulinum A exotoxin reconstituted using isotonic sodium chloride with and without preservative: a double-blind, randomized controlled trial. Arch. Dermatol., 138(4), 510–14.Google Scholar

Lewis, C. (2002). Botox cosmetic: a look at looking good. FDA Consumer, 36(4), 11–13.Google Scholar

Goodman, G. (2003). Diffusion and short-term efficacy of botulinum toxin A after the addition of hyaluronidase and its possible application for the treatment of axillary hyperhidrosis dermatologic surgery. Dermatologic Surgery, 29(5), 533–8.Google Scholar

Finn, C., Cox, S. E. and Earl, F. (2003). Social implications of hyperfunctional facial lines. Dermatol. Surg., 29, 450–5.CrossRef Google Scholar

Carruthers, A., Carruthers, J. and Said, S. (2005). Dose-ranging study of botulinum toxin type A in the treatment of glabellar rhytids in females. Dermatologic Surgery, 31(04), 414–22.CrossRef Google Scholar PubMed

Carruthers, A. and Carruthers, J. (2005). Prospective, double-blind, randomized, parallel-group, dose-ranging study of botulinum toxin type A in men with glabellar rhytids. Dermatologic Surgery, 31(10), 1297–303.CrossRef Google Scholar PubMed

Carruthers, J. A., Lowe, N. J., Menter, M. A., Gibson, J., Nordquist, M., Mordaunt, J., Walker, P. and Eadie, N. (2002). A multicenter, double-blind, randomized, placebo-controlled study of the efficacy and safety of botulinum toxin type A in the treatment of glabellar lines. Journal of American Academy of Dermatology, 46, 840–9.CrossRef Google Scholar PubMed

Carruthers, A., Carruthers, J. and Cohen, J. (2003). A prospective, double-blind, randomized, parallel group, dose-ranging study of BOTOX® in female subjects with horizontal forehead rhytids. Dermatologic Surgery, 29, 462–7.Google Scholar

Kane, M. A. (2003). Classification of crow's feet patterns among caucasian women: the key to individualizing treatment. Plastic and Reconstructive Surgery, 112(Suppl. 5), S33–S39.CrossRef Google Scholar PubMed

Goldman, M. (2003). Festoon formation after infraorbital botulinum-A toxin: a case report. Dermatologic Surgery, 29(5), 560.Google Scholar PubMed

Lowe, N.et al. (2005). Double-blind, randomized, placebo-controlled, dose-response study of the safety and efficacy of botulinum toxin type A in subjects with crow's feet. Dermatologic Surgery, 31(3), 257–62.CrossRef Google Scholar PubMed

Cohen, J. and Dayan, S. (2005). Botulinum toxin type A in the treatment of dermatochalasis: a prospective study evaluating temporal brow elevation. American Academy of Dermatology, 52(Suppl. 3), 86.Google Scholar

Flynn, T., Carruthers, J. A., Carruthers, A. and Clark, R. (2003). Botulinum A toxin (BOTOX®) in the lower eyelid: dose-finding study. Dermatol. Surg., 29(9), 943–50.Google Scholar

Tamura, B., Odo, M., Chang, B., Cuce, L. and Flynn, T. (2005). Treatment of nasal wrinkles with botulinum toxin. Dermatologic Surgery, 31(03), 271–5.CrossRef Google Scholar PubMed

Carruthers, J. and Carruthers, A. (1999). Practical cosmetic Botox® techniques. Journal of Cutaneous Medicine and Surgery, 3(Suppl. 4), S49–52.CrossRef Google Scholar

Pessa, J. E. (1992). Improving the acute nasolabial angle and medial nasolabial fold by levator alae muscle resection. Annals of Plastic Surgery, 29(1), 23–30.CrossRef Google Scholar PubMed

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