Botulinum toxins type A injections are likely exceeding 10 million yearly worldwide. While it is easy to “push the plunger” to achieve some result, precise, efficacious, and safe application for functional and aesthetic enhancement is deceptively more challenging. Accurate physical assessment is critical. Advanced techniques are surprisingly more difficult, and the pharmacology of toxins must be understood. Radio frequency nerve ablation is a newer approach that requires even more knowledge, precision, and preprocedure preparation while offering longer or permanent duration and the ability to achieve real-time results. In addition, it can be combined easily with surgical procedures.
Tetanus toxin and botulinum toxins type A and B inhibit glutamate, gamma-aminobutyric acid, aspartate, and met-enkephalin release from synaptosomes. Clues to the locus of action.