Aim of the workThe aim of this study was to compare manifest and concealed accessory pathway regarding:Clinical characteristics such as: gender, prevalence of heartThe length of action of Botox was ranged from 4-6 months .Botox injection is relatively a simple procedure without any surgical intervention and can be done rapidly in an office setting.In conclusion, botulinum toxin-A (Botox) is a safe and effectivetherapy for management of hyperfunctional facial wrinkles including transverse forehead lines ,glabellar frown lines,and periorbital wrinkles (crow’s feet).