Summary Joseph Giacometti MD , Michael Yen MD
Since its initial FDA approval over 2 decades ago, the use of botulinum toxin in clinical practice has flourished. In the field of oculofacial plastic surgery, it has emerged as a safe and effective noninvasive component of the treatment repertoire for various cosmetic and functional indications in the periorbital region. During this time frame, as its therapeutic indication profile has expanded, several new formulations of the toxin have also been developed. Physicians who consider the implementation of botulinum toxin in their practice must be well versed in these products, given the variety of toxins available and the differences they possess with regard to their chemical composition. However, although the various toxins possess distinct characteristics at a molecular level, they all act in a similar manner and exhibit comparable efficacy with excellent results if administered properly by an experienced physician.