Novel Cosmetic Uses of Botulinum Toxin in the Head and Neck
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USE OF BOTULINUM TOXIN IN OTORHINOLARYNGOLOGY (A D’SOUZA AND CL NG, SECTION EDITORS)
Novel Cosmetic Uses of Botulinum Toxin in the Head and Neck Isabel Fairmont 1 & Andrew Winkler 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Injection of botulinum toxin is the most commonly performed nonsurgical cosmetic procedure worldwide. New applications and formulations of botulinum toxin have become available for clinical use. This review presents recent advancements, applications, and new formulations of botulinum toxin. We also discuss issues regarding brand uniformity, safety, and patient satisfaction. Recent Findings Novel cosmetic uses for botulinum toxin include the treatment of androgenic alopecia, oily skin, and others. Two new toxin formulations include daxibotulinumtoxinA, with a duration of 6 months, and botulinum toxin E, with a fast onset of action (24 h) and duration of 2–4 weeks. Recent trends find increased usage among younger adults and men. Summary Cosmetic injection of botulinum toxin into the head and neck remains an area of innovation and evolution. Research continues to support the finding that botulinum toxin formulations are equally safe and efficacious. Keywords Botox . Botulinum toxin . Cosmetic . Facial plastic surgery . Neuromodulator
Introduction The first cosmetic use of botulinum toxin occurred in the USA in 1987. Dr. Richard Clark, having knowledge of the toxin’s functional use in strabismus and blepharospasm, had the pioneering idea of using the toxin to improve forehead symmetry following a surgical facial nerve injury. Optimistically, he reached out to the Food and Drug Administration, who agreed to allow him to use it in this way as a compassionate extension of an existing protocol [1]. Finding success with the new technique, Dr. Clark published his findings in 1989 [2], which was followed in 1992 by the Carruthers’ landmark paper describing the cosmetic treatment of glabellar frown lines [3]. Since then, the indications and applications of This article is part of the Topical collection on Use of Botulinum Toxin in Otorhinolaryngology * Andrew Winkler [email protected] Isabel Fairmont [email protected] 1
Department of Otolaryngology—Head & Neck Surgery, University of Colorado School of Medicine, 12631 E. 17th Avenue, MS B-205, Aurora, CO 80045, USA
botulinum toxin have increased logarithmically. “Botox” is a household name, and the manufacture of botulinum toxin, considered one of the world’s deadliest poisons, is a multibillion-dollar industry. Botulinum toxins generate their effect at the presynaptic nerve terminal. The toxin protein interacts with and cleaves intracellular soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) proteins, which are involved with the transport and attachment of acetylcholine-filled vesicles to the presynaptic cell membrane. The fragmentation of SNARE proteins renders the vesicles unable to fuse to the neurosynaptic cleft, thereby blocking neurotransmit
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