There has been an enormous increase in the use of botulinum toxin in aesthetic applications over the last few years, especially after serotype A (Botox) was licensed to treat rhytides in the region of the glabella. It is only recently that cosmetic practitioners have extended the use beyond the upper facial third. Currently, the toxin is used for a wide variety of applications, including reduction of wrinkles in any facial location, the mental or cervical regions or on the chest, to paralyse the depressor anguli oris, to flatten the nasolabial creases, to paralyse the mentalis muscle, to lift the brow, either medially or laterally, to diminish facial shadows and to make the jaws and cheeks appear smoother in outline when viewed from any angle. Furthermore, dermatologists have found it a useful treatment in cases of hyperhidrosis affecting the axilla or palms, when other treatments, whether topical or systemic, have failed. As botulinum toxin may be dispersed by massaging the injected muscle, this should be avoided, both by the clinician and the patient. Patients should be discouraged from reapplying make-up for a period afterwards and advised to rest on the day of injection.