Botulinum toxin type A for facial aesthetic enhancement: role in facial shaping.

The application of injectable chemodenervation with botulinum toxin type A has become a useful and significant tool for facial rejuvenation. Since its original discovery and descriptions of its use for improvement of dynamic facial lines and furrows, botulinum toxin type A has been shown to be effective in a host of other applications. Because of its synergistic effects, it is used as an adjunctive agent for a variety of procedures, from injectable facial soft-tissue augmentation to brow lifts. The art of using botulinum toxin type A, or Botox (Allergan, Irvine, Calif.), has evolved from a technical procedure to one that is influenced by aesthetic judgment and applications that extend beyond line eradication to improve facial form and shape.