Introduction
Botulinum Toxin 159
Nagasai C. Adusumilli, Elizabeth Tanzi, Alastair Carruthers, Jean Carruthers and Ada Regina Trindade de Almeida
Chapter Contents
Synonyms: Botulinum toxin type A, botulinum A exotoxin, BoNT-A; onabotulinumtoxinA – BOTOX®/BOTOX® Cosmetic; abobotulinumtoxinA – Dysport®, Azzalure®; incobotulinumtoxinA – Xeomin®/Bocouture®; prabotulinumtoxinA-xvfs – Jeuveau®; daxibotulinumtoxinA-lanm – DAXXIFY® Botulinum toxin type B, BoNT-B; rimabotulinumtoxinB – MYOBLOC®
Key features
Botulinum toxin (BoNT) causes chemodenervation of muscles by blocking acetylcholine release
BoNT is also capable of inhibiting the release of other neurotransmitters, such as substance P, noradrenaline, calcitonin gene-related peptide, and glutamate from a variety of synaptosomal and neuronal systems
Injections of BoNT type A (BoNT-A) that weaken or relax muscles can smooth hyperfunctional lines and change the contour of the face and neck
Adjunctive use of BoNT-A with soft-tissue augmentation or laser resurfacing is beneficial, particularly in active regions such as the perioral and periocular areas
The cosmetic effects of BoNT-A typically last months and may increase with subsequent injections
In addition to its effect on musculature, BoNT-A successfully denervates sweat glands, serving as an effective alternative treatment for hyperhidrosis, and it can also improve the pain, swelling, and discoloration associated with Raynaud phenomenon
Complications (e. g. eyelid ptosis) are generally caused by diffusion of the toxin to non-targeted muscles and can be minimized by using concentrated doses and careful technique