Botulinum Toxin: Surely, We Can Do Better? Optimizing Results Beyond On-Label Techniques and Teaching. Facial expressions and their emotional attributes are essential as an adjunct to verbal communication and for nonverbal communication. Botulinum toxin (BoNTA) used to limit wrinkles induced by aging changes on expressive faces. However, suboptimal injection techniques can lead to undesirable outcomes, such as brow ptosis, unnatural eyebrow elevation, flattening of the cheeks, and unnatural smiles. It is the intention here to investigate whether “on-label” standard injection techniques may be a contributing factor to poor results.
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