Botulinum Toxin in Facial Rejuvenation by Kate Coleman-Moriarty

By Kate Coleman-Moriarty

Written by means of a most sensible specialist within the box, this source introduces the reader to the pharmacology of botulinum toxin and describes and the complete diversity of thoughts for its optimum administration-including secure dealing with, the choice and evaluation of sufferers, strength problems and pitfalls, and asthetic thoughts. It additionally offers comparative info on different modalities comparable to laser and hyaluronic acid, in addition to strength danger components, so readers can select the simplest technique for every sufferer.

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A tired-looking patient will be far less happy than a partially frowning one. Complaint: the patient looks tired This is due to an unexpected lack of brow movement in a moderately lowbrowed person. It can also occur when botulinum toxin diffuses too far medially. The tonic orbicularis under the eyelid is loosened, allowing the infraorbital fat pad to protrude. Spend time reassuring patients that the maximum effect is transient, and that the extra muscles involved have received only the ‘edge’ of the treatment as the toxin diffused.

General and local anesthesia Administering botulinum toxin at the time of general or local anesthesia gives less predictable results. Avoid injecting botulinum toxin to the eye zone in patients who have had local anesthesia for blepharoplasty. Also avoid giving botulinum toxin in the post-operative phase where there is local oedema, in order to reduce the risk of distal diffusion and, for example, perioral palsy. Pregnancy and breast feeding The teratogenicity of botulinum toxin has not yet been established and so it is contraindicated in pregnancy and during breast-feeding.

7 The management of crow’s feet ‘Crow’s feet’ are the wrinkles that form with age at the outer corners of the eyes. They are due to contraction of the orbicularis oculi muscles (Fig. 1). Their treatment with botulinum toxin is usually straightforward but certain aspects must be considered carefully first. The functions of the orbicularis oculi muscle are to close the eye, to drain the tear film, and to create facial expressions. Contraction of this muscle can also drag on the lateral third of the eyebrow, contributing to drooping of the brow with age.

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