Cosmetic applications of botulinum toxin in oculofacial region.

The objective of this review was to analyze and compare the efficacy and safety of botulinum toxin for cosmetic oculofacial use, published in articles during the last two decades. Article searches for relevant data were conducted in 2009 for the last two decades. Controlled studies showed statistically significant improvement in glabellar, frontal, and lateral canthal wrinkles after botulinum toxin therapy. Standardized documentation using clinical examinations and grading by the patient and physician supports the efficacy ofbotulinum toxin in the treatment of dynamic wrinkles in the glabellar region, frontal region, and lateral canthal area. Complications and unwanted effects associated with the treatment were rare and temporary. Botulinum toxin is safe and efficacious in the treatment ofglabellar, frontal and lateral canthal wrinkles. Additional studies are required to assess the efficacy of botulinum toxin for other cosmetic indications. All available data suggest that the possible side effects are infrequent and completely resolved in short term after botulinum therapy. Future research is needed to determine the ideal efficacious dose and concentration for each anatomic area. The use of botulinum toxin in conjunction with laser resurfacing treatment, facial surgical procedures, facial fillers, and other treatment modalities requires further study.