This is the second edition of Benedetto’s book, which claims to have revised and updated its material, as well as to have improved and evolved the techniques in the style of an instruction manual, while introducing newer and innovative ways to utilise the different botulinum toxins available.

It begins with a detailed account of the pharmacology and mechanism of action of botulinum and other neurotoxins, before moving on to the applied anatomy of the facial muscles. The bulk of the book lies in the following three chapters, which deal with the cosmetic uses of botulinum toxin in various areas of the face, neck and upper chest, covering in detail the variations in facial shape and distribution of facial creases. There are step by step descriptions of how, where, what concentration and what volume to inject, illustrated with many before and after photographs showing injection points, as well as anatomical diagrams of the targeted facial muscles.

There are sections on how to create an effect, such as elevating a brow, as well as discussing potential complications. The subsequent chapters deal with some conventional uses of botulinum toxin such as in the treatment of Raynaud’s phenomenon, hyperhidrosis and keloids, as well as some less conventional uses such as targeting pain in post-herpetic neuralgia, complex regional pain syndrome, facial and lower limb contouring, and breast lifting! There are also sections on medicolegal considerations and consent.

The book is well illustrated with colour photographs and detailed anatomical diagrams, which are helpfully repeated on many pages. This book was published in the USA by a group of dermatologists in 2011, making its scope for UK practitioners a little narrow, with some aspects having since been updated. However, as a user’s guide, its coverage of most of the common uses of botulinum toxin, will make this book a useful asset to those who inject.

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Hilal I Bahia

St John's Hospital, Livingston, UK.

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