Application of Botulinum Toxin Injection in Plastic Surgery

ABSTRACT

Botulinum toxin type A is a neurotoxin produced by clostridium botulinum that blocks the presynaptic release of acetylcholine at the neuromuscular junction. This blockade of the neuromuscular junction is definitive, but the existence of nerve sprouting explains the reversible nature of the paralysis induced by injection of this toxin. The clinical effect appears between the 3rd and 7th day after injection. The author had experienced 218 cases from January 1999 to September 1999. We injected toxin on forehead (96 cases), glabella (91 cases), crow's feet (88 cases), neck (12 cases), nasolabial fold (9 cases), masseter muscle (8 cases), and chin (7 cases). The author obtained wrinkles decreased significantly. The effect during the period of activity of the toxin, which lasted 3 to 6 months after injection and masseter muscle area lasted 6 to 9 months. The advantage of botulinum toxin injection is the effective treatment with wrinkles in upper half of face and neck and no disturbance in daily life. The disadvantage of botulinum toxin injection is the feeling of masked face after injection, short duration, and sometimes unwilling facial expression.