Some wrinkles and unsightly facial expressions are due to overactivity of the underlying facial musculature. Botulinum A exotoxin reversably paralyses selected muscles. Botulinum toxin has been used to correct facial cosmetic concerns. This paper describes the authors' experience with the cosmetic use of botulinum toxin. The areas that can be treated, the appropriate technique for each area and special considerations such as dose, dilution, and relevant anatomy are discussed. Our results have been published previously and are referenced in this paper. Botulinum toxin is safe and effective in the management of some facial lines and wrinkles. Its use is associated with a high degree of patient and physician satisfaction.