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Updated: Aug 25, 2026

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
Published on: November 9, 2016
Botulinum toxin A for the treatment of lateral periorbital rhytids
David W Kim1, Jason Cundiff, Dean M Toriumi
1Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, 400 Parnassus Avenue A-730, San Francisco, CA 94143-0342, USA. dKim@ohns.ucsf.edu
Abstract:
The lateral periorbital area represents one of the earliest and most bothersome facial stigmata of aging. Although traditional techniques have had limited success in treating the static cutaneous component to rhytid formation in this region, they have been largely unsuccessful in addressing the dynamic hyperkinetic lines that are created by the activity of the lateral orbicularis oculi muscle. Botox A injection represents a safe and reproducible technique to selectively denervate muscle activity in this troublesome area. This minimally invasive technique has led to significant improvement of periorbital lines, either when used as a single agent or in combination with other methods (Fig. 3). As more experience is gained with this toxin, as well as other Botox serotypes, continued progress is likely to occur in this area, as well as in other facial regions.
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