Abstract

Objectives: To understand the differences between the various proprietary Botulinum toxin As (BTX-As) available in the USA. To identify and appreciate the subtle differences between the available BTX-As that will influence how treatment injections should be performed. To choose the proper BTX-A product in order to create the most beneficial results for individual patients. Introduction: OnabotulinumtoxinA, brand named BOTOX, was approved for cosmetic purposes in 2002. Since then, there have been additional BTX-As developed, distributed worldwide and approved for cosmetic use in the USA by the FDA. All the available BTX-A products contain the same neurotoxin molecule, but because of different propriety accessory proteins and stabilizing molecules, the different brand named products vary in subtle ways which influence the manner in which they should be injected. Materials / method: The BTX-As currently available in the USA will be identified and categorized according to their individual proprietary differences. These subtle variations in the BTX-A products will determine how they can be optimally utilized when injecting them for cosmetic purposes. Results: The different BTX-A products will be differentiated by how long their results last, how easily they diffuse within the skin and muscle, how quickly the product takes effect and how reliably reproducible are their results. Conclusion: Depending on whether one is injecting BTX-A on-label for cosmetic or therapeutic purposes or off-label for cosmetic or therapeutic purposes, selecting the appropriate BTX-A is important. All the different named BTX-As contain the same neurotoxin molecule, but because of different propriety accessory proteins and stabilizing molecules, these BTX-A products vary in subtle ways which influence the manner in which they should be injected. These differences will be identified and the injection techniques emphasized.