1. Date of download: 6/26/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Botulinum A Exotoxin for Hyperfunctional Facial Lines: Where Not to Inject Arch Dermatol. 2002;138(9):1180-1185. doi:10.1001/archderm.138.9.1180 Injecting within 1 cm of the middle to lateral aspects of the brow, medial to the temporal fusion line, can cause brow ptosis. In rare cases, eyelid ptosis can occur. Figure Legend:

2. Date of download: 6/26/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Botulinum A Exotoxin for Hyperfunctional Facial Lines: Where Not to Inject Arch Dermatol. 2002;138(9):1180-1185. doi:10.1001/archderm.138.9.1180 Brow ptosis can be partially corrected by weakening the corresponding brow depressors with small quantities of toxin. For instance, the Carruthers technique entails placement of 10 U of toxin between the brows and 3 to 5 U under each lateral aspect of the brow. An injection into the lateral brow depressors can make the eye appear more open, lift the brow, and accentuate the eyebrow arch. Figure Legend:

3. Date of download: 6/26/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Botulinum A Exotoxin for Hyperfunctional Facial Lines: Where Not to Inject Arch Dermatol. 2002;138(9):1180-1185. doi:10.1001/archderm.138.9.1180 When injecting glabella frown lines, forceful injections toward the medial canthus can cause eyelid ptosis. Although medial canthus injections are not desirable, injecting the orbicularis under the lateral brow is the correct placement for a lift of the lateral aspect of the brow. Figure Legend:

4. Date of download: 6/26/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Botulinum A Exotoxin for Hyperfunctional Facial Lines: Where Not to Inject Arch Dermatol. 2002;138(9):1180-1185. doi:10.1001/archderm.138.9.1180 Large volumes should not be injected directly at the lateral canthus because diffusion can rarely cause diplopia, strabismus, and even eyelid droop. Figure Legend:

5. Date of download: 6/26/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Botulinum A Exotoxin for Hyperfunctional Facial Lines: Where Not to Inject Arch Dermatol. 2002;138(9):1180-1185. doi:10.1001/archderm.138.9.1180 Injection for "bunny lines" should be on the lateral aspect of the nasal wall, not on the medial aspect of the cheek. Injecting the upper cheek deeply below the zygoma can induce a Bell palsy–like appearance. Figure Legend:

6. Date of download: 6/26/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Botulinum A Exotoxin for Hyperfunctional Facial Lines: Where Not to Inject Arch Dermatol. 2002;138(9):1180-1185. doi:10.1001/archderm.138.9.1180 Do not inject everywhere at once. Diffusion and overlap can result in diminished expressivity or brow ptosis. Figure Legend:

7. Date of download: 6/26/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Botulinum A Exotoxin for Hyperfunctional Facial Lines: Where Not to Inject Arch Dermatol. 2002;138(9):1180-1185. doi:10.1001/archderm.138.9.1180 Two ways to inject safely and effectively. A, Carruthers eyebrow lift and forehead treatment. B, Klein forehead and glabella treatment. In both cases, place injections outside the bony rim of the orbit. Figure Legend:

8. Date of download: 6/26/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Botulinum A Exotoxin for Hyperfunctional Facial Lines: Where Not to Inject Arch Dermatol. 2002;138(9):1180-1185. doi:10.1001/archderm.138.9.1180 A "quizzical" or "Jack Nicholson" look can occur if active frontalis muscles are not injected. This can be corrected by injecting 3 U of toxin 2 cm above each brow and medial to the temporal fusion line. Figure Legend:

9. Date of download: 6/26/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Botulinum A Exotoxin for Hyperfunctional Facial Lines: Where Not to Inject Arch Dermatol. 2002;138(9):1180-1185. doi:10.1001/archderm.138.9.1180 The lines of the lip and the cobblestoning of the chin can be improved with small quantities of toxin. Cobblestoning can be improved by a single injection of 5 to 10 U directly into the point of the chin with massage. Figure Legend:

10. Date of download: 6/26/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Botulinum A Exotoxin for Hyperfunctional Facial Lines: Where Not to Inject Arch Dermatol. 2002;138(9):1180-1185. doi:10.1001/archderm.138.9.1180 Downward curl of the corners of the lips may be treated by injections at the jaw edge lateral to the first fold. Injecting the orbicularis oris may cause idiosyncratic lip movement. Figure Legend: