Institutional members access full text with Ovid®

Share this article on:

Advancements and Refinement in Facial Neuromodulators

Kordestani, Reza M.D.; Small, Kevin H. M.D.; Rohrich, Rod J. M.D.

Plastic and Reconstructive Surgery: October 2016 - Volume 138 - Issue 4 - p 803–806
doi: 10.1097/PRS.0000000000002569
Cosmetic: Video+
Press Release

Summary: The use of neuromodulators has increased by approximately 748 percent from 2000 to 2014 and has become an integral adjunct for facial rejuvenation. Knowledge of facial anatomy, accurate facial analysis, and familiarity with neurotoxin characteristics will minimize complications and optimize results. Current U.S. Food and Drug Administration–approved neurotoxins in the United States include onabotulinumtoxin A (Botox), abobotulinumtoxin A (Dysport), and incobotulinumtoxin A (Xeomin). The dosage and effect of these products are not interchangeable, so practitioners should master the utility and response of one product before trying the other products. All products have equivalent success in appropriately trained hands; the senior author (R.J.R.) favors no particular neurotoxin. This article provides a stepwise approach to treat dynamic facial rhytides with neuromodulators, including indications, facial analysis, preparation and injection technique, post-procedure care, and complications.

Supplemental Digital Content is available in the text.

Dallas, Texas

From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.

Received for publication January 31, 2016; accepted May 17, 2016.

Disclosure: The authors have no financial interests in this research project or in any of the techniques or equipment used in this study. Dr. Rohrich is a volunteer member of the Allergan Alliance for the Future of Aesthetics and receives instrument royalties from Eriem Surgical, Inc., and book royalties from Taylor and Francis Publishing. No funding was received for this article.

Video Plus content is available for this article. A direct URL citation appears in the printed text; simply type the URL address into any Web browser to access this content. Clickable links to the material are provided in the HTML text of this article on the Journal’s Web site (

Rod J. Rohrich, M.D., University of Texas Southwestern Medical Center, Department of Plastic Surgery, 1801 Inwood Road, Dallas, Texas 75235,

©2016American Society of Plastic Surgeons