Third, the BTA injection was commonly placed into the musculature directly or indirectly involved with the incision tension. Although several studies used intradermal injection,as most facial muscles directly insert into the underlying dermis, injected BTA could also diffuse into the muscular layer. It is feasible for plastic surgeons to perform tailored treatment based on wound characteristics to facilitate individual outcomes, with the primary intention being to maintain a balance between minimizing the underlying muscle tension as much as possible and maintaining function of mimetic muscles. Further studies about the dose-effect relationship are warranted to decrease dosages and number of injections.