Learning Objectives: After reading this article, the participant should be able to: 1. Recognize the various types of botulinum toxins and their differences. 2. Identify current indications, both approved and off-label. 3. Inject botulinum toxin to counteract various natural aging processes, including facial descent and rhytides. Summary: Botulinum neurotoxin is a naturally synthesized microbial protein that has been applied in the management of various disorders. In particular, its application within the realm of plastic surgery is addressed in this article. After evaluating the medical literature, the seven indications with the highest quality trials for the use of botulinum neurotoxin in plastic surgery were as follows: rhytides, facial dystonias, facial nerve palsy and aberrant regeneration, hand tremor, palmar hyperhidrosis, neuropathic pain, and upper limb spasticity.
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