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 growi ng popularity over recent years. Understanding the clinical use and ef fects of botulinum toxin requires a thorough understanding of the musc ular anatomy of the treatment areas. OBJECTIVE. The purpose of this ar ticle is to review the anatomy of the frown, forehead, and periocular regions. Function of individual muscles is discussed to understand pro per injection technique. CONCLUSIONS. The anatomy of the frown, forehe ad, and periocular regions is complex. Individual muscles are tightly intertwined and treatment of one anatomic region may affect many diffe rent muscles. A complete understanding of the anatomy of the upper fac e is essential to ensure proper injection technique, safe and predicta ble results as well as anticipating complications. (C) 1998 by the Ame rican Society for Dermatologic Surgery, Inc.