Understanding botulinum toxin. Surgical anatomy of the frown, forehead, and periocular region.
BACKGROUND
Cosmetic denervation of hyperfunctional facial lines using botulinum toxin (Botox, Allergan, Inc., Irvine, CA) has gained growing popularity over recent years. Understanding the clinical use and effects of botulinum toxin requires a thorough understanding of the muscular anatomy of the treatment areas.


OBJECTIVE
The purpose of this article is to review the anatomy of the frown, forehead, and periocular regions. Function of individual muscles is discussed to understand proper injection technique.


CONCLUSIONS
The anatomy of the frown, forehead, and periocular regions is complex. Individual muscles are tightly intertwined and treatment of one anatomic region may affect many different muscles. A complete understanding of the anatomy of the upper face is essential to ensure proper injection technique, safe and predictable results as well as anticipating complications.
Wieder
J M
JM
Division of Dermatology, UCLA School of Medicine, USA.
Moy
R L
RL
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005152:Facial Muscles / Q000033:anatomy & histology* / Q000294:innervation; D006801:Humans; D009121:Muscle Denervation; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D015595:Skin Aging
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A