Botulinum toxin sounds like a terrible name. And it is true, Botox is a highly toxic agent that can kill people in very small doses, so why can we apply it safely? Why is it in full swing in cosmetic surgery and popular all over the world? This is because we apply the concentration and dose is far below its safety limit, so it is very safe. In fact, its application has a very interesting story. In 1986, a Canadian ophthalmologist named Joan Carasso applied the drug to the eye. In 1986, a Canadian ophthalmologist named Joan Carasso was applying Botulinum toxin type A to treat eye muscle spasms and accidentally discovered that this neurotoxic drug used to paralyze muscles could make the wrinkles under the patient’s eyes disappear. She then told her husband, who is a professor of dermatology, about this unexpected surprise. The couple then began to collaborate on this topic, eventually introducing Botulinum toxin type A into the field of skin wrinkle reduction, and published the first report on it in 1990, triggering the so-called “Botox revolution” in the history of cosmetology. After the United Kingdom and the United States, China was the third country to produce this cosmetic product on its own and started using it in 1999. So what is the principle of Botox for wrinkle reduction? The reason why Botox is effective in removing wrinkles is that it inhibits the release of acetylcholine from the presynaptic membrane of peripheral motor nerve endings, blocking the transmission of information between nerves and muscles, thus causing flaccid paralysis of muscles. The wrinkles in human are mostly the result of the action of facial expression muscles, and Botox eliminates the wrinkles by paralyzing the muscles so that the muscles have no pulling power and stretching. Botox injection wrinkle removal has the characteristics of small trauma, quick effect, convenient operation, cheap, and does not affect work. Compared with traditional chemical peels, facelifts, collagen injections, fat recharging or small incisions for wrinkle removal, it only requires a certain dose of Botox to be injected into the operation area, and the whole process takes only a few minutes and is almost painless. The downside is that Botox wrinkle reduction is time-sensitive. After Botox is injected into the wrinkles, the wrinkles will gradually flatten out after 1 to 7 days. The maintenance effect of wrinkle reduction is usually 3 to 6 months. To maintain the cosmetic effect for a long time, 2 to 3 injections per year are required. It is known that using Botox to remove wrinkles, general crow’s feet, forehead lines, frown lines, nose lines and neck wrinkles can be removed. However, it is best suited for early, less visible wrinkles. If the patient’s wrinkles are deep, they can be combined with the application of tissue fillers (such as hyaluronic acid, etc.); if the skin is very lax, then traditional skin lift surgery can be considered. Therefore, Botox wrinkle removal is not a panacea, but its definite results and very few complications make it the number one application for cosmetic surgery. It is worth noting that Botox wrinkle removal cannot be used on pregnant women, nursing mothers, patients with severe myasthenia gravis, those with allergies, those with ptosis and those with internal diseases such as heart, liver, lung and kidney. A serendipitous discovery has forged an inevitable part of the history of beauty.