Level 3 - Advanced Botulinum Toxin: Cosmetic Mid Face, Lower Face/Neck & Myofascial Pain

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Level 3 – Advanced Botulinum Toxin: Cosmetic Mid Face, Lower Face/Neck & Myofascial Pain

Have you noticed an increase in the number of patients presenting with migraine, headache and/or TMD in your practice?

Are you interested in advanced botulinum toxin techniques for improving facial aesthetics below the eyes?

Level 3 course is an advanced clinical botulinum toxin course which provides an in-depth analysis of symptoms, conditions and treatment using therapeutic levels of botulinum toxin that can help treat patients with chronic pain. It also covers advanced aesthetic applications of using botulinum toxin to reduce the signs of aging in the mid-face, lower-face and neck, as well as correcting gummy and canted smiles. This advanced course reviews advanced techniques including MFE (Mid Face Expression) with Dr. Warren Roberts.



  • Pre-requisite: Successful completion of Level 2, plus proficiency using the PTIFA Marking & Injection Techniques (20 cases is a suggested recommendation).
  • Requirements: A patient model, current copy of your license and malpractice insurance is required.
  • Practitioner Tuition (Dentist, Physician, Nurse): $3,400 (plus GST)
  • Team Member Tuition (Auxiliary Staff): $799 (plus GST)
  • Patient Model: A discounted rate of $6/unit is charged for each patient model having treatment in the clinic. Practitioners are responsible for the fee of their patient model.

All funds are in Canadian Dollars. Please review our Registration Policy prior to registering.

Register For The Course

Upcoming Course Dates

Looking for Level 3 for Team Members?


Course Overview

Level 3 includes an online component (28hrs), plus a two-day clinical session held in Vancouver, BC.


Online Didactic:

The online portion of Level 3 includes the following five sections.

  1. Advanced Botulinum Toxin
  2. Mid-Face Expression
  3. Lower Face
  4. Neck/Platysma
  5. Myofascial Pain

The online portion introduces how PTIFA pioneered mid-face injections and coined the term “Mid Face Expression” (MFE). Use of the Roberts Facial Rejuvenation Photography series allowed you to see the lines, creases and folds created by the MFE. Using precise markings, the PTIFA Injection Technique and low dosage, you will learn how to control the musculature creating these unwanted infra-orbital lines, naso-jugal grooves, bunny lines, smoker’s lines and naso-labial folds. Habitual subconscious activation of the lower face muscles turns the smile line into a “green bean down” appearance. These expressions blemish the skin with lines that exhibit sadness and depression. Learn how to turn the smile into a “green bean up”.

Understand how activation of the Platysma musculature accentuates the muscles of the lower face and turns the smile to a “green been down”. In addition, subconscious activation of Platysma enlarges the soft tissue, creating horizontal ‘necklace lines’ and creates the hated anterior, lateral and posterior jowls. The posterior ‘PTIFA Platysma bands when present, indicate hyper muscular activity indicative of bruxing, grinding, TMD & tension type headache. Learn how sensory input from the head & neck and how overload of central and peripheral sensitization on the trigeminal nucleus can lead to referred pain.


Clinical Session

The clinical portion of Level 3 includes a two-day hands-on session always held on a Friday and Saturday.


Dr. Roberts provides an in-depth review of anatomy focused on the of the mid-face, lower-face and neck. In this integrative skull & cadaver lab, learn how surface features and bony landmarks relate to underlying musculature.



Day 2 is an advanced clinical hands-on practicum where you will have the opportunity to inject aesthetic cases focused on the mid-face, lower-face & neck, as well as myofascial pain patients while incorporating EMG analytics.


  1. Identify and mark precise anatomical facial landmarks for placing botulinum toxin cosmetically in the mid-face, lower-face & neck.
  2. Diagnose and inject botulinum toxin (aka Dysport®/Botox®) for predictable cosmetic results in the mid-face, lower-face & neck.
  3. Diagnose and inject botulinum toxin (aka Dysport®/Botox®) for predictable therapeutic results including myofascial pain (migraine, headache & TMD).
  4. Describe the importance of EMG analytics in the differential diagnosis when treating therapeutic patients and myofascial pain (migraine, headache & TMD).


  • Levator Labii Superioris Alaeque Nasi
  • Levator Labii Superioris
  • Nasalis
  • Zygomaticus Major and Minor
  • Risorius, Buccinator
  • Levator and Depressor Anguli Oris
  • Orbicularis Oris
  • Levator and Depressor Labii
  • Superioris/Inferioris
  • Mentalis and Platysma
  • Treatment Protocols for Migraine and Myofascial Pain
  • Masseter, Temporalis,
  • Sphenomandibularis
  • Medial & Lateral Pterygoid
  • Digastrics, Mylohyoid, Ligaments

Format & CE/CME

Level 3 includes an online didactic section (28 hours + exam), and 2-days of hands-on (16 hours). Level 3 includes 44 CE/CME credits upon successful completion of the hands-on session. Upon registration, access to the online Level 3 course material is provided for one year.

Areas Trained To Treat

Level 3 graduates are trained to treat the following areas:

  1. Mid-Face Expression (MFE) – facial lines & wrinkles around the eyes & nose (aka infra-orbital lines, naso-jugal grooves and “bunny lines”)
  2. Lower Face – facial lines & wrinkles located around the mouth/lips (aka “smoker’s lines” and naso-labial folds)
  3. Gummy Smiles & Canted Smiles – smiles that show too much gum or uneven smiles
  4. Platysma Bands – visible vertical bands in the neck
  5. Myofascial Pain – incorporating EMG analytics to reduce headache, migraine, TMD & facial pain symptoms

Graduates are also able to digitally store, compare and create portfolios of their photographs using FACETEC software.


Learn how higher dosages than those used for aesthetic treatment alone result in reduction of headaches and migraines. A threshold dosage, carefully placed, must be reached in order to obtain therapeutic relief.

Learn how incorporating EMG analytics when treating your therapeutic patients can assist with determining the muscle activity, dosage, timing and improved records & patient care.

Understand the relationship between the secondary and tertiary mechanisms of action of botulinum toxin and the synergy between aesthetic and therapeutic results. Further understand the relationship between “looking good” and “feeling good”.

Learn how to significantly reduce the amount of dermal filler in the mid-face and lower-face after developing an understanding of how to use advanced levels of botulinum toxin.

Successfully treatment plan and mark your advanced botulinum toxin patients with confidence, after attending the advanced hands-on anatomy review focusing on the mid-face, lower-face and neck.

Ability to review the online course videos as often as you wish by accessing the didactic material online.

Course FAQs


 As a physician, I was quite sceptical to have a dentist teach me about Botox... however, by the end of the Level 2 course I felt more than pleasantly surprised, indeed it was the best and most fun CME I have attended in years. I left the weekend just wanting more and more and more.. signed up for Level 3 the next morning.

Dr. Pieter Slabbert


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