Description
This title in the PROCEDURES IN COSMETIC DERMATOLOGY SERIES presents up-to-the-minute, practical guidance on botulinum toxin injection techniques shaping today's practice. Succinctly written and lavishly illustrated, it focuses on procedural how-to's and offers step-by-step advice on proper techniques, pitfalls, and tricks of the trade-so you can refine and hone your skills...and expand your surgical repertoire. You'll find current, to-the-point guidance on the cosmetic use of the toxin - edited by pioneers in the field, Drs. Jean and Alastair Carruthers. Implement the newest procedures into your practice immediately and confidently-with the outstanding guidance you'll find in this volume of the PROCEDURES IN COSMETIC DERMATOLOGY SERIES.Covers the hottest topics-including botox aesthetics, facial treatments, neck treatment, adjunctive treatment, pain relief, and facial asymmetry-all in one concise, accessible volume. Features a wealth of color illustrations and photographs that depict cases as they present in practice.Discusses common pitfalls and emphasizes how to optimize outcomes, enabling readers to improve their technique.Highlights emerging topics in the field, with guidance on the newest developments in cosmetic surgery.Includes a comprehensive, instructional DVD containing video clips of techniques and procedures as well as the experts' hints and tips.Use of fillers in combination with Botox to better sculpt the lower faceCoverage of new fillers like Juvederm, Evolen
Chapter
Hyperfunctional muscular uses
Cervical dystonia (spasmodic torticollis)
Autonomic nervous system use
Afferent nervous system / pain syndromes / anti-inflammatory
Glandular and secretory cell modulation
2 History of onabotulinumtoxinA therapeutic
Identification, isolation, and characterization
Exploration of clinical potential
Developed indications for onabotulinumtoxinA
Primary focal hyperhidrosis
Adult post-stroke spasticity
Neurogenic detrusor overactivity
3 History of cosmetic botulinum toxin
Patient zero and the first clinical trials
4 Basic science: BOTOX® Cosmetic
Dissociation of NAPs from the 150 kDa neurotoxin
Internalization and translocation
Recovery of neurotransmitter release
Potential actions on the sensory system
Clinical pharmacology of onabotulinumtoxinA in aesthetics
Unique dosing of neuromodulators
Clinical studies performed for abobotulinumtoxinA
Treatment of the upper face
Treatment of the lower face
Properties of incobotulinumtoxinA
Clinical performance of incobotulinumtoxinA
Safety summary in neurological conditions
Clinical experience with incobotulinumtoxinA
The total face approach with incobotulinumtoxinA
3D basic science: Myobloc®
Pharmacology of botulinum toxin B
Myobloc® in the aesthetics practice
Efficacy in the treatment of hyperkinetic rhytides
Myobloc® in the treatment of hyperhidrosis
Treatment considerations for Myobloc®
Microbiological, physicochemical, and biochemical profiles
Clinical studies for Neuronox®
Reconstitution and handling
The use of Neuronox® in Asians
9 Comparison of botulinum toxins
Types of botulinum toxin A
Compositional differences
Diffusion / field of effect
Need for transcutaneous delivery systems
Potential approaches to transcutaneous delivery of BoNT-A
Potential applications of topical BoNT-A
11 Reconstitution / Dilution
Reported substances used in the reconstitution process
Epinephrine and / or lidocaine
Variations in the reconstitution process
Foam during reconstitution
Shelf life after reconstitution
Limb muscle dystonias / spasticity
Injection technique (see Video ‘Botulinum Toxin Glabella’)
Botox® (onabotulinumtoxinA) (Fig. 12.3)
Dysport® (abobotulinumtoxinA) (Figs 12.4 and 12.5)
Xeomin® (incobotulinumtoxinA) (Fig. 12.6)
Myobloc® (rimabotulinumtoxinB)
13 Eyebrow height / shaping
Eyebrows and attractiveness
15 Treatment of crow’s feet
Anatomy of ‘crow’s feet’ lateral orbital rhytides
16 Infraorbital / upper and lower eyelids
Patient assessment and selection
Indications and techniques
Hypertrophic orbicularis, infraorbital rhytides, and widening of the eye
Lid ptosis, malposition, and asymmetry
Adjunctive treatments for the lid
Lasers and light-based therapies
17 Treatment of the mid-face with botulinum toxin
‘Bunny’ / nasal sidewall scrunch lines
Levator labii superioris alequae nasii
18 Orbicularis oris, mentalis, depressor anguli oris
Differences in the use of BoNT for the upper and lower face
Patient selection for botulinum toxin perioral and chin rejuvenation
Preparation of botulinum toxin solution
Dosage and injection technique
19 Platysma and the Nefertiti Lift®
The platysma: anatomy and dynamic aesthetic clinical implications
Injection techniques for the neck
Potential complications of the Nefertiti Lift®
20 The masseters and their treatment with botulinum toxin
Surface anatomy of the masseter muscle
Raison d’être for botulinum injection of the masseters in the lower face
Treatment of the masseter muscle for shaping and beautification of the lower face
Racial / ethnic differences in photoaging
Safety and efficacy of botulinum toxins in darker skin types
Ethnic specific applications of botulinum toxin
Lasers and light-based therapies
Non-ablative light sources
23 Focal axillary hyperhidrosis
Clinical assessment of hyperhidrosis
Use of botulinum toxin type B for hyperhldrosis
Techniques for non-axillary hyperhidrosis
24 Palmo-plantar hyperhidrosis
Marking the treatment areas
25 The future of botulinum toxin
Topical versus injectable
Changes in the toxin molecule
Central effects of the neurotoxin
Botulinum Toxin
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