Is there an advantage or disadvantage to Botox placement within the periosteum?

The crunching sound comes from the dulled tip of the needle!  It happens when a dulled needle penetrates a layer of fascia (connective tissue) over lying the muscle. This layer of fascia is thickest in the glabella (i.e. you won't often hear crunching around the crows feet).  On a related note, the Botox needs to be placed in the muscle to work.  if you actually got it inside the periostium, it would not work unless it diffused into the muscle.The needle can be dulled enough to cause the crunching sound by touching it to the glass bottle the Botox comes in,  passing through the rubber stopper, or, worst of all, banging the needle into the bone of your forehead!  I take extra care to always use a sharp needle...not only will it make no noise at all, but a super sharp needle hurts less as well!Great question, and thanks for asking!  Best wishes, MKB

Botox placement requires only superficial cutaneous placement as it selectively migrates to the muscles.