Botulinum toxin is a minimally invasive technique that has revolutionized the cosmetic approach to rejuvenation of the aging face. The interest in and the usage of botulinum toxin A over the past several years for cosmetic indications by physicians have increased almost exponentially. This has been a truly amazing process to behold. Naturally, there are a number of reasons for this phenomenal explosion of interest. Facial wrinkles are frequently caused by repeated muscle contraction. Botulinum A exotoxin can produce weakness or paralysis of these muscles and offers a novel approach for the treatment of certain facial rhytides and improved cosmetic appearance. This cosmetic use is not FDA approved and is thus considered off-label. The disappearance of wrinkles through the paralysis of these muscles, although temporary, is extremely popular with both patients and physicians. There is a low incidence of side effects and it is a relatively easy technique to perform. For these reasons, botulinum toxin A has gained rapid and enthusiastic acceptance. BOTOX (Allergan, Inc, Irvine, CA) is now a well-established method for the treatment of facial rhytides. Its major cosmetic indications in the facial area are glabellar frown lines, crow’s feet, horizontal lines of the forehead, and reshaping of the brow. Some of the intermediate applications are the lines on nasal scrunch along the side of the nose, opening the eye, chin dimpling, and neck rejuvenation. Minor applications are in the lip lines and the corners of the month.