Update on botulinum toxin use in facial plastic and head and neck surgery.
OBJECTIVE
The purpose of this review is to discuss current trends in the medicinal use of botulinum toxin in head and neck and facial plastic surgery. The basic science of botulinum toxin is presented along with a comparison of the subtypes currently available on the market. Site-specific applications of botulinum toxin in the head and neck region are presented.


RESULTS
The use of botulinum toxin continues to expand, both in volume and in number of applications. The main application of botulinum toxin in facial plastic surgery is in the effacement of dynamic or hyperkinetic facial lines. The granting of US Food and Drug Administration approval for the use of Botulinum Toxin type A in the treatment of glabella lines marks a major milestone for the more widespread usage of this product in cosmetic settings. Additional cosmetic applications include crow's feet, marionette lines, and platysma banding. Noncosmetic applications in the head and neck include dystonias (including torticollis), facial and generalized muscle spasms, migraine headaches, hyperhidrosis, spasmodic dysphonia, sialorrhea, gustatory sweating, and involuntary movement disorders.


CONCLUSIONS
The use of botulinum toxin in the treatment of hyperkinetic conditions and disorders of excessive salivation is well established and enjoys an excellent safety profile. The cosmetic use of botulinum toxin continues to expand. The chronic use of botulinum toxin specifically for cosmetic purposes is worthy of additional study.
Batniji
Rami K
RK
University Ear Nose and Throat of Northeastern New York, LLP & The Center for Facial Plastic Surgery and Division of Otolaryngology-Head and Neck Surgery, Albany Medical College, Albany, New York 12208-3479, USA.
Falk
Arthur N
AN
D001905:Botulinum Toxins / Q000145:classification / Q000627:therapeutic use* / Q000633:toxicity; D005145:Face / Q000601:surgery; D006257:Head / Q000601:surgery*; D006801:Humans; D007273:Injections, Intramuscular; D009333:Neck / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D013518:Surgery, Plastic / Q000379:methods; D016896:Treatment Outcome
D001905:Botulinum Toxins