The utilization of botulinum neurotoxin for facial rejuvenation has been progressively expanding into multiple upper, mid, and lower facial and neck applications. Success in these areas is dependent upon a number of factors, above all a sophisticated understanding of the underlying facial anatomy. In addition, although published consensus recommendations can guide dosing and injection site placement, expert technical application is critical, as is individualized treatment for each patient, based on an aesthetic assessment. This includes an evaluation of the patient's unique functional anatomy and a frank discussion of the patient's desires and goals. Only by addressing these considerations can the best possible outcomes be consistently achieved.