BACKGROUND Injections of botulinum toxins have become a major therapeutic tool for cosmetic dermatologists. This therapy is quite useful as an adjuvant to the step-by-step skin rejuvenation program. OBJECTIVE To review our method of dilution and injection and to present case studies. METHODS Patients received either tangential or perpendicular injections of botulinum toxin into the mimetic muscles of the face and neck to document the preferred method of injection. The botulinum toxin also was diluted to 10, 15, or 20 cc to study its long-term potency. RESULTS Tangential injections of botulinum toxin produced the longest and most effective results. Dilution studies indicated that 15-cc dilution was possible in patients who previously had not been exposed to botulinum toxin, but that 10-cc dilution was more uniformly effective during repeat injections. CONCLUSION With the proper method of injection and dilution, the botulinum toxin can be an useful adjuvant for building cosmetic surgery practice.