KEY POINTS
*Botulinum toxin functions by paralyzing or weakening muscles of facial expression and thereby diminishing the appearance of mimetic lines
*Hyaluronic acid fillers have a wide variety of clinical applications in facial aesthetic medicine, and variation in filler density determines indication for location and depth of injection
*Chemical peels predictably rejuvenate the face and vary in depth of penetration from superficial to deep; chemoexfoliation coagulates proteins in the skin and induces regeneration of collagen and keratinocytes
*Topical aesthetic medicines are gaining popularity for the treatment of acne, photodamage, fine rhytids, and dyschromia
*Patients with significant horizontal forehead rhytids often have a standing static elevation of the brow by activation of the frontalis— be judicious with neurotoxin injection to avoid brow ptosis
*Inadequate weakening of the lateral frontalis can result in lateral brow “peaking” and can be corrected with a small amount of neurotoxin in the lateral frontalis
*The depth of penetration of a chemical peel depends on the mechanism of chemoexfoliation
*Nonself-neutralizing peels such as GA will continue to keratocoagulate for the duration of their contact with the skin and can reach deeper layers by prolonged skin contact
*Self-neutralizing chemical peels, such as salicylic acid, reach an endpoint after which they no longer penetrate the dermis
*Patients should wait for 6 to 12 months after stopping isotretinoin (Accutane) before undergoing surgical or nonsurgical cosmetic procedures such as laser resurfacing or chemical peels
