Botulinum Toxins and Soft Tissue Fillers

Abstract

Botulinum toxin and soft tissue filler injections are the most common minimally invasive cosmetic procedures with growing use every year, given their relatively quick effects, short procedure time, and fast recovery. Botulinum toxins result in temporary paralysis of the facial muscles injected by blocking the release of acetylcholine from nerve terminals. The use of botulinum toxins has expanded from ophthalmic medical indications such as blepharospasm, hemifacial spasm, torticollis, and strabismus to growing cosmetic indications to treat facial rhytids at the glabella, forehead, eyelids, perioral areas, and cervical region. Soft tissue fillers combat facial aging by providing volume supplementation. The substances injected in dermal fillers include hyaluronic acid, polylactic acid, calcium hydroxyapatite, polymethylmethacrylate, and autologous fat. Complications from both procedures are infrequent but can have devastating consequences if the procedures are performed incorrectly. Administration by an experienced injector and appropriate understanding of the facial anatomy are essential to obtain an acceptable cosmetic outcome and minimize complication risks. This chapter will focus on the available botulinum toxin and soft tissue filler products and their uses, as well as appropriate injection techniques and potential complications.