A wrinkle is grouped into dynamic and static. Static wrinkle is again divided into fine lines or grooves/deep grooves. Dynamic wrinkles can be seen in the glabella (frown lines) when frowning or in the periorbital (around the eyes) area when smiling. Glabella grooves and nasolabial (laugh lines) folds are examples of deep grooves. The wrinkle formation process begins with dynamic wrinkles, and then the dynamic wrinkles become fixed as fine lines. With age, fine lines turn into deep grooves with the gradual loss of the underlying soft tissue. Although botulinum toxin is generally believed to be the basic treatment for wrinkles, it cannot be applied in the treatment of all wrinkles. The best dramatic responses with botulinum toxin treatment are achieved in patients with dynamic wrinkles and no or minimal static wrinkles. In patients with static wrinkles, the response develops slowly and the best response is achieved after two to three consecutive treatments due to the cumulative effect. Deep static lines do not respond to botulinum toxin treatment alone. These patients should be combined with treatments such as fillers or skin resurfacing for optimal results. Surgical intervention may be required in patients older than 65 years of age who complain of severe static wrinkles and laxity. Realistic expectations should be emphasized during the evaluation and consultation process of patients. The main indications for botulinum toxin in the treatment of wrinkles are forehead lines, glabella frown lines, periorbital (around the eyes) lines, lines on the back of the nose, fine lines around the lips, and platysmal bands, where it serves to paralyze the facial muscles of the underlying face. However, botulinum toxin is ineffective in treating grooves. Therefore, filler injection should be recommended in the treatment of grooves including the nasolabial fold, marionette lines, and frown lines of the glabella. Some static wrinkles, such as horizontal neck lines and necklace lines, are not affected by botulinum toxin treatment because they are present from birth. On the other hand, fine lines caused by habitual contractions of the mimetic muscles of the face can be corrected to some extent with botulinum toxin. Example areas for fine lines where toxin treatment may be beneficial include the forehead, glabella, and lateral canthal (crow's feet) area. The mechanism of botulinum toxin correcting fine lines can be hypothesized in different ways. First, it can weaken the muscle tone of the underlying facial muscles that attach directly to the skin. As a result, fine lines at rest appear to be smoothed. Secondly, paralysis of the facial facial muscles attached to the dermis causes lymphatic insufficiency, and subsequent dermal edema may occur in the skin. The result can correct fine wrinkles and pores on the face. Botulinum toxin is ineffective in some types of dynamic wrinkles. Examples include horizontal under-eye wrinkles and zygomatic wrinkles caused by the mouth corner elevator muscles when smiling. Botulinum toxin injection should not be performed in the cheek area and nasolabial folds where dynamic wrinkles in facial expressions deepen. If botulinum toxin is injected into the corner of the mouth elevators, such as the zygomatic major, an awkward and asymmetrical smile may occur. Such dynamic wrinkles can only be corrected by intradermal hyaluronic acid injection many times. Applications where the toxin is used Crow's feet area Widening the eye opening Infraorbital (under-eye) wrinkles Horizontal forehead lines nGlabella frown lines Bunny lines Dropped nose tip Gummy smile Nasolabial fold Asymmetric smile Facial paralysis With the smile next to the nose wing called alar band The resulting protrusion Pouch mouth Dooping corners of the mouth Cobblestone chin (the indented appearance that occurs on the chin when the lower lip is raised) Platismal band Masseter hypertrophy Temporal muscle hypertrophy Salivary gland hypertrophy Hyperhidrosis (Excessive sweating) Nefertiti neck Mesobotox - Microbotox - Hyabotox Migraine