Management of Facial Cosmesis and Blepharospasm with Botox: A 24 Year Ophthalmic Plastic Surgical Perspective

Since 1980 Botulinum Toxin type A has been used by ophthalmic plastic surgeons in the United States, at first for blepharospasm, hemi-facial spasm, strabismus, and then for cosmetic enhancement and facial rejuvenation. It has become the foundation of non-invasive facial rejuvenation, used in combination with multiple modalities -injectable fillers (Restylane and Perlane), ablative and non-ablative lasers, non-laser radio frequency therma-lifting, and laser-assisted blepharoplasty. The use of Botox has become an elevated art form. The goal is a natural enhancement, a softening and not complete obliteration of eve…