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<article xlink="http://www.w3.org/1999/xlink" dtd-version="1.0" article-type="dermatology" lang="en">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher">JOHS</journal-id>
      <journal-id journal-id-type="nlm-ta">Journ of Health Scien</journal-id>
      <journal-title-group>
        <journal-title>Journal of HealthCare Sciences</journal-title>
        <abbrev-journal-title abbrev-type="pubmed">Journ of Health Scien</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">2231-2196</issn>
      <issn pub-type="opub">0975-5241</issn>
      <publisher>
        <publisher-name>Radiance Research Academy</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">461</article-id>
      <article-id pub-id-type="doi">http://dx.doi.org/10.52533/JOHS.2025.51201</article-id>
      <article-id pub-id-type="doi-url"/>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Dermatology</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Long-Term Effects of Repetitive Botulinum Toxin Use on Facial Muscle Architecture&#13;
</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Alyamani</surname>
            <given-names>Nawal</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Aldousari</surname>
            <given-names>Abdullah</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Albloushi</surname>
            <given-names>Fatmah</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Alhumoud</surname>
            <given-names>Zainab</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Alassaf</surname>
            <given-names>Suad</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Abdelghani</surname>
            <given-names>Abdelmalek</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Alarman</surname>
            <given-names>Mawaddah</given-names>
          </name>
        </contrib>
      </contrib-group>
      <pub-date pub-type="ppub">
        <day>3</day>
        <month>12</month>
        <year>2025</year>
      </pub-date>
      <volume>5</volume>
      <issue>12</issue>
      <fpage>705</fpage>
      <lpage>712</lpage>
      <permissions>
        <copyright-statement>This article is copyright of Popeye Publishing, 2009</copyright-statement>
        <copyright-year>2009</copyright-year>
        <license license-type="open-access" href="http://creativecommons.org/licenses/by/4.0/">
          <license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.</license-p>
        </license>
      </permissions>
      <abstract>
        <p>Botulinum toxin, a toxic protein produced by Clostridium botulinum, has gained widespread popularity for both therapeutic and cosmetic purposes. Initially approved for the treatment of conditions like blepharospasm and strabismus, its aesthetic applications have expanded to include glabellar lines, crow’s feet, forehead wrinkles, and other facial concerns. However, the growing use of Botulinum toxin in cosmetic procedures, particularly repetitive or long-term injections, raises concerns regarding its adverse effects on muscle architecture. This narrative review examines the literature on the long-term impact of Botulinum toxin on muscle structure and function. The mechanism of action involves the inhibition of acetylcholine release at neuromuscular junctions, resulting in temporary muscle paralysis. Although the effects are reversible, repeated exposure has been linked to muscle atrophy, fiber disorganization, and neuromuscular remodeling. Several experimental and clinical studies have reported structural changes, including loss of muscle mass, target fiber formation, neurogenic atrophy, and increased endomysial connective tissue. Several studies further support these findings, revealing reductions in muscle cross-sectional area and persistent abnormal signal intensities months after injection. Complications such as ptosis, asymmetry, dysphagia, and aesthetic dissatisfaction are documented, often attributed to toxin diffusion or incorrect injection technique. Moreover, variation in reported complication rates highlights the lack of standardized adverse event reporting. Understanding the long-term consequences of Botulinum toxin is crucial, especially in aesthetic practices where patient safety and treatment precision are paramount. This review highlights the importance of using Botulinum toxin judiciously, adhering to anatomical guidelines, and implementing more robust reporting systems for adverse events.&#13;
</p>
      </abstract>
      <kwd-group>
        <kwd>Botulinum toxin</kwd>
        <kwd> Muscle atrophy</kwd>
        <kwd> Cosmetic complications</kwd>
        <kwd> Repetitive injection effects</kwd>
        <kwd> Neuromuscular remodeling</kwd>
      </kwd-group>
    </article-meta>
  </front>
</article>