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

This surgeon does not know what he/she is talking about.  The good news is that there will be plenty of physicians in your community who actually know where to place the treatment.  Botox does no good at the periosteal level.  The muscles we want to treat insert into the skin not the periosteum.  There is an entire glide plane that separates the periosteal plan from the more superficial muscles of facial expression.  At best, this is a very inefficient way of perform a botox treatment.  At worst is that this product can drift in this plane causing unwanted side effects.

Thank you for sharing your question.  There is no benefit to Botox placement at the periosteum as Botox works best when placed where the nerves meet the muscle, which is more superficial than the periosteum.  The crunch felt during Botox is more commonly related to the connective tissue of a patient and use of a slightly dulled needle. Hope this helps.

 Botox is never placed in the periosteum. 
For the best result, Botox should be injected directly into muscle.