The cosmetic use of botulinum toxin type B in the upper face.

Facial wrinkles involving the forehead, glabellar, and/or periorbital regions are a common esthetic problem and are directly related to overactivity of the underlying facial musculature. For instance, the development of glabellar wrinkles is related, at least in part, to the dynamics of the underlying procerus, corrugator supercilii, and orbicularis oculi muscles. Facial lines are considered problematic because they produce the appearance of aging. In some cases, they can also be misinterpreted as manifestations of negative emotions (eg, anger, anxiety, sadness), fatigue, or stress. In recent years, botulinum toxin injections have become one of the most popular therapies for the treatment of hyperfunctional facial lines. After injection, the toxin acts to paralyze or weaken facial mimetic muscles. This reduces or eliminates the appearance of wrinkles and is extremely safe.