Hyaluronic acid filler and botulinum Neurotoxin delivered simultaneously in the same syringe for effective and convenient combination aesthetic rejuvenation therapy. [2010.09]
Facial aesthetics and rejuvenation techniques have been evolving, with the most commonly applied techniques being the use of hyaluronic acid fillers and botulinum neurotoxins. Because of complementary actions, it is common for both products to be used in the same anatomical sites to optimize outcomes, either administered consecutively at one visit or at two separate visits...
Cosmetic use of botulinum toxin-a affects processing of emotional language. [2010.07]
How does language reliably evoke emotion, as it does when people read a favorite novel or listen to a skilled orator? Recent evidence suggests that comprehension involves a mental simulation of sentence content that calls on the same neural systems used in literal action, perception, and emotion...
Treating glabellar lines with botulinum toxin type A-hemagglutinin complex: a review of the science, the clinical data, and patient satisfaction. [2010.04.26]
Botulinum toxin type A treatment is the foundation of minimally invasive aesthetic facial procedures. Clinicians and their patients recognize the important role, both negative and positive, that facial expression, particularly the glabellar frown lines, plays in self-perception, emotional well-being, and perception by others.
Botulinum toxin: examining duration of effect in facial aesthetic applications. [2010]
Patient satisfaction with botulinum toxin treatment is a key success factor in aesthetic procedures and is governed by the interaction of numerous variables. Duration of effect is important because it influences retreatment intervals as well as affecting cost and convenience to the patient.
Safety and tolerability of onabotulinumtoxinA in the treatment of facial lines: a meta-analysis of individual patient data from global clinical registration studies in 1678 participants. [2009.12]
BACKGROUND: OnabotulinumtoxinA for the treatment of facial lines is a widely used cosmetic medical procedure and, as such, the safety and tolerability profile is of interest to health care providers and patients. Based on data from individual studies that were conducted according to regulatory guidelines to provide adequate safety and efficacy data to support product licensure (registration studies), the overall benefit:risk profile of onabotulinumtoxinA for facial lines has been favorable. OBJECTIVE: Our objective was to increase statistical power through meta-analysis to detect treatment group differences in adverse event (AE) incidence that may not have been evident in individual registration studies... CONCLUSION: This meta-analysis confirms the safety and tolerability of onabotulinumtoxinA for glabellar and lateral canthal lines, at the doses studied, based on the most comprehensive controlled safety analysis of onabotulinumtoxinA performed to date. The AEs observed were generally mild to moderate; most treatment-related AEs were related either to physical injection of product or local pharmacologic effects. Even with the increased statistical power of a large sample size, no new onabotulinumtoxinA-associated AEs emerged.
[Does dilution have an impact on cosmetic results with BoNT/A? Complex-protein-free BoNT/A for treatment of glabella lines] [2009.10]
BACKGROUND: In this 2-armed, randomized study we investigated the efficacy and tolerability of complex-protein-free botulinum neurotoxin type A (BoNT/A), applied in two different dilution volumes for treatment of glabellar lines... CONCLUSION: Complex-protein-free botulinum neurotoxin type A in both dilutions effectively reduced severity of glabellar lines. There was no statistically significant difference in efficacy between the two dilutions.
Efficacy and safety of botulinum toxin type A in the treatment of lateral crow's feet: double-blind, placebo-controlled, dose-ranging study. [2009.10]
BACKGROUND: Botulinum toxin type A (BoNT-A) is frequently used to treat crow's feet; the optimal dose for each toxin preparation should be established. OBJECTIVE: To compare the efficacy and safety of three doses of BoNT-A with placebo to treat crow's feet... CONCLUSION BoNT-A (15, 30, or 45 U) is an effective and safe treatment for mild to severe crow's feet.
Botulinum toxin in facial rejuvenation: an update. [2009.10]
Since its initial approval by the US Food and Drug Administration (FDA) 20 years ago for the treatment of strabismus, hemifacial spasm, and blepharospasm in adults, botulinum toxin (BTX) has become one of the most frequently requested products in cosmetic rejuvenation around the world... Although recent reports have questioned the safety of BTX, 25 years of therapeutic and over 20 years of cosmetic use has demonstrated an impressive record of safety and efficacy when used appropriately by experienced injectors.
Safe botulinum toxin type A injection in patients with history of eyelid ptosis. [2009.06]
BACKGROUND: Ptosis is an important side effect of frown correction by botulinum toxin type A (BTX-A). The most likely reason of eyelid ptosis is the diffusion of the toxin to levator palpebrae superioris muscle through orbital septum while the toxin is injected into the corrugator muscle. OBJECTIVES: In this pilot study, to prevent ptosis, we evaluated the efficacy of BTX-A injection at superior middle aspect of the corrugator muscle instead of the common injection site located above the medial eyebrow head... CONCLUSION: Employing this method a very satisfactory outcome was obtained while no ptosis was observed. Therefore, we recommend this safe technique for treating patients with a history of eyelid ptosis.
[Different botulinum toxins and their specifications] [2009.05]
Botulinum neurotoxin A was the first developed for therapeutic and then esthetic uses, Botox first and then Dysport. These two products differ on a few points, explaining their nonequivalence of units: American and British tests of the mouse LD50 units based on solutions that were not identical and 500microg vs 150microg serum albumin dose in the excipient...
[Botulinum toxin injection techniques in the lower third and middle of the face, the neck and the decollete: the "Nefertiti lift"] [2009.05]
Although correction of the dynamic wrinkles of the upper part of the face is the major indication for botulinum toxin, there are also many possibilities for the middle and lower thirds of the face and neck. However, these injections are more delicate and require an experienced operator who has excellent knowledge of the muscles of these regions, their functions, the antagonist actions exercised on other muscles, particularly in terms of the complex equilibrium of the mouth...
Treatment of hypertrophic scars with intralesional botulinum toxin type A injections: a preliminary report. [2009.05]
BACKGROUND: Hypertrophic scar is the abnormal appearance of wound healing that usually causes major physical, psychological, and cosmetic problems. Treatment of the hypertrophic scar still is a dilemma due to the lack of effective and excellent methods and agents. Recent reports show that botulinum toxin type A (BTX-A) improves wound healing. Therefore, the authors hypothesized that BTX-A may be favorable for the improvement of hypertrophic scars... CONCLUSION: For the treatment of hypertrophic scars, doctors and patients both found BTX-A acceptable because of its better therapeutic results. Its effect of eliminating or decreasing hypertrophic scars was promising.
Reduction of pain and anxiety prior to botulinum toxin injections with a new topical anesthetic method. [2009.05]
PURPOSE: To evaluate the safety and efficacy of vapocoolants (topical skin refrigerants) to induce skin anesthesia and relieve patient anxiety and pain prior to cosmetic botulinum injections... CONCLUSIONS: Vapocoolants represent a safe and effective means to reduce patient discomfort and anxiety before and during botulinum toxin type A treatments for glabellar area indications.
Botulinum toxin cosmetic therapy correlates with a more positive mood. [2009.03]
BACKGROUND: It has been suggested that botulinum toxin A (BTX-A) treatment for frown lines can also be used as a treatment for depression. A psychological mechanism for this effect is reviewed in which paralysis of the corrugator (frown) muscles leads to less facial feedback for negative emotions. Consequently, a negative affect is harder to maintain and so the person has a more positive mood... CONCLUSION: The results support the facial feedback view that frowning can make one unhappier. Treatments that prevent frowning correlate with reduced negative mood.
A four-month randomized, double-blind evaluation of the efficacy of botulinum toxin type A for the treatment of glabellar lines in women with skin types V and VI. [2009.03]
BACKGROUND: Histologic differences (e.g., dermal thickness, collagen fibers) between Caucasian and other racial and ethnic groups may affect wrinkle formation and influence responses to treatment with botulinum toxin type A (BoNT-A). OBJECTIVE: To evaluate the degree and duration of efficacy of 20 and 30 U of BoNT-A for the treatment of glabellar lines in African-American women with skin types V and VI... CONCLUSION: These results indicate that doses of 20 and 30 U of BoNT-A demonstrate efficacy and safety in African-American women with skin types V and VI.
Botulinum neurotoxin: the ugly duckling. [2009]
This review presents a brief account of the most significant biological effects and clinical applications of botulinum neurotoxins, in a way comprehensive even for casual readers who are not familiar with the subject. The most toxic known substances in botulinum neurotoxins are polypeptides naturally synthesized by bacteria of the genus Clostridium.
An overview of the cosmetic treatment of facial muscles with a new botulinum toxin. [2009]
Botulinum toxin (BTX) is used nowadays in a much more differentiated way with a much more individualized approach to the cosmetic treatment of patients. To the well known areas of the upper face new indications in the mid and lower face have been added... In this paper the three-year clinical experience with average dosages for an optimal outcome in the treatment of facial muscles with a newly developed botulinum toxin type A (Xeomin) free from complexing proteins is presented.
The effect of botulinum toxin type A on full-face intense pulsed light treatment: a randomized, double-blind, split-face study. [2008.08]
CONCLUSION: The adjunctive use of BTX enhances the improvement in small wrinkles and fine lines, and possibly erythema, achieved with IPL alone.
Questioning the need to use Botox within 4 hours of reconstitution: a study of fresh vs 2-week-old Botox. [2008.07]
OBJECTIVE: To determine whether injection with botulinum toxin type A (Botox; Allergan Inc, Irvine, California) reconstituted with preservative-free saline (0.9% isotonic sodium chloride) after 2-week cold storage in a refrigerator (4 degrees C) or freezer (-20 degrees C) is less efficacious than injection with freshly reconstituted Botox... CONCLUSIONS: No measurable difference was found in the potency or duration of efficacy of Botox in the treatment of forehead rhytids after 2 weeks of refrigeration or freezing compared with fresh reconstituted Botox. When Botox, fresh or stored, is given at an adequate dose to cause full paralysis of the desired muscle, the duration of the muscle paralysis is dependent on the physiologic rate for the motor nerve to reestablish neural transmission.
Patient satisfaction with different botulinum toxin type A formulations in the treatment of moderate to severe upper facial rhytids. [2008.06]
BACKGROUND: The clinical characteristics of botulinum toxin type A (BoNTA) depend on the formulation used. OBJECTIVE: To evaluate whether switching BoNTA formulations affects patient satisfaction... CONCLUSIONS: Efficacy, satisfaction, and product preference ratings strongly favor the use of BoNTA-Allergan over BoNTA-Ipsen in the treatment of upper facial lines. Many patients who are satisfied with BoNTA-Allergan treatment become less satisfied if they are switched to BoNTA-Ipsen.
Comparisons among botulinum toxins: an evidence-based review. [2008.06]
BACKGROUND: Botulinum neurotoxin treatment is the most common aesthetic procedure in the United States. A number of serotypes and formulations are available worldwide. Similarities and differences among these toxins were evaluated by reviewing the existing literature... CONCLUSIONS: Injection patterns, techniques, dilutions diffusion, and injection volumes established for a specific formulation of botulinum neurotoxin are not likely to be applicable to other formulations, and formulations are not interchangeable by any single conversion ratio. A large proportion of the clinical literature documents the aesthetic uses of the Allergan formulation of botulinum toxin type A. Additional studies are needed to establish optimal procedures for the Ipsen formulation and botulinum neurotoxin, and for diverse aesthetic uses.
Botulinum toxin a can positively impact first impression. [2008.06]
BACKGROUND First impression is influenced by facial appearance and improved by cosmetic surgery. OBJECTIVE We wanted to determine if treatment with botulinum toxin A (BTxnA) would improve first impression... The smile/relax variable was a more important predictor for academic performance and occupational success scores.
Advanced botulinum toxin techniques against wrinkles in the upper face. [2008.03]
The use of botulinum toxin type A for facial rejuvenation is one of the most common procedure in esthetic medicine. Overall clinical and study experience with botulinum toxin type A for facial enhancement has confirmed that it is effective and safe even in the long term... This depends on a precise understanding of the underlying anatomy and physiology of the individual muscles and their interactions, as well as on individual patient's characteristics, including goals and expectations.
Botulinum neurotoxin type A in facial aesthetics. [2007.06]
Injection of botulinum neurotoxin type A has rapidly become the most common non-surgical cosmetic procedure performed, due to its exceptional safety profile, as well as its ability to rejuvenate and enhance a number of facial areas... It is important for clinicians using these products to understand these differences as they relate to achieving desired outcomes for patients who seek improved facial aesthetics.
A randomized, evaluator-blinded, two-center study of the safety and effect of volume on the diffusion and efficacy of botulinum toxin type A in the treatment of lateral orbital rhytides. [2007.05]
CONCLUSIONS: This is a small study and it may be that dilution does affect BTX result. We were, however, unable to detect any difference in this study, which suggests that the degree of dilution, at least within a fivefold margin, has only a small effect on the results of BTX injection in the lateral orbital area.
A pilot study on the effect of epinephrine on botulinum toxin treatment for periorbital rhytides. [2007.04]
BACKGROUND: Relaxation of hyperactive facial muscles by injection of botulinum toxin type A (BOTOX, Allergan Inc., Irvine, CA) represents the most common cosmetic procedure performed in the United States. OBJECTIVE: The objective of this split-face randomized double-blind study was to determine the effect of epinephrine (EPI) on the efficacy of BOTOX treatment of muscle hyperactivity in the upper face... CONCLUSION: To our knowledge, we are the first to test under randomized double-blind conditions the effect of EPI on efficacy of BOTOX. Our data suggest that addition of EPI may accelerate the rate of onset as well as the short-term efficacy of BOTOX for treatment of periorbital rhytides.
Complications with the use of botulinum toxin type A for cosmetic applications and hyperhidrosis. [2007.03]
In dermatology, botulinum toxin is now most often used to reduce dynamic facial creases and treat primary focal hyperhidrosis. The exemplary safety record of this medication is such that after nearly 2 decades, it is not known to have any long-term adverse events... Patients who do experience uncommon, transient effects can be reassured that these are not dangerous and will resolve completely without intervention.
Botulinum toxins for facial wrinkles: beyond glabellar lines. [2007.02]
Botulinum toxin type A (BTX-A) has been used for years with excellent results for upper facial cosmetic applications. Because of this success, the use of BOX-A for facial aesthetics has expanded to the lower facial and neck regions... In this article, the authors present their experience with BTX-A in the lower face and neck, and compare and contrast their current practices with those reported by others.
Repeated botulinum toxin A injections for the treatment of lines in the upper face: a retrospective study of 4,103 treatments in 945 patients. [2007.01]
BACKGROUND: Although botulinum toxin type A (BoNT-A) is a common aesthetic intervention, there are few published data on treatment over more than two cycles. OBJECTIVE: To evaluate the effectiveness/safety of repeated doses of BoNT-A (Dysport, Ipsen Ltd., Slough, UK) in the upper face for reduction of wrinkles... CONCLUSIONS: Long-term, repeated injections of BoNT-A for corrections of wrinkles in the upper face yield a continuously high level of safety and effectiveness in actual practice.
Patient-reported outcomes with botulinum toxin type A treatment of glabellar rhytids: a double-blind, randomized, placebo-controlled study. [2007.01]
CONCLUSIONS: Botulinum toxin type A can achieve specific goals of treatment that are important to patients and help them feel that they look younger than their current age.
Low- and high-dose botulinum toxin A treatment: a retrospective analysis. [2006.04]
Upper limb botulinum toxin A doses in children are empirical, determined by the size of the muscle, seeking to avoid excessive weakness and deterioration of function. This study reports the effects and side effects of botulinum toxin treatment on upper limb impairment and function in 18 children with spastic or dystonic hyperactivity...
Efficacy and safety of 3- and 5-injection patterns (30 and 50 U) of botulinum toxin A (Dysport) for the treatment of wrinkles in the glabella and the central forehead region. [2006.03]
OBJECTIVE: To investigate the efficacy and safety of 2 injection site patterns (3- and 5-injection patterns [30 and 50 U]) of botulinum toxin A (Dysport; Ipsen Pharma, Ettlingen, Germany), in the treatment of glabellar and central forehead wrinkles... CONCLUSIONS: The 3 central injection sites are essential for the treatment of glabellar wrinkles. The 2 additional injection sites in the forehead region, targeting the frontalis muscle, did not significantly improve efficacy.
Diplopia associated with the cosmetic use of botulinum toxin a for facial rejuvenation. [2006.03]
We report three cases in which cosmetic injections of botulinum toxin A around the eye caused diplopia. Diplopia was due to inferior oblique paresis, which was bilateral in two cases.We suggest that consent for periocular botulinum toxin procedures should include a warning about diplopia.
Comparative evaluation of the safety and efficacy of botulinum toxin type A and topical creams for treating moderate-to-severe glabellar rhytids. [2006.02]
BACKGROUND: Several nonprescription products purport similar or better outcomes than botulinum toxin type A (Botox Cosmetic, Allergan Inc., Irvine, CA, USA) for treating wrinkles, but these have not been documented in comparative clinical trials. Patients spend millions of dollars annually on the topical products, yet there are, to date, no data to support any of the claims made. OBJECTIVE: To compare the efficacy and safety of botulinum toxin type A with placebo and three topical products in treating moderate-to-severe glabellar lines... CONCLUSION: Botulinum toxin type A provided significantly greater efficacy and patient satisfaction in the treatment of glabellar frown lines than StriVectin-SD, Wrinkle Relax, and HydroDerm, and in the objective measurements used, none of the topical preparations were better than botulinum toxin.
Psychosocial aspects of botox in aesthetic surgery. [2006.01]
BACKGROUND: The human preoccupation of experimenting with potentially toxic substances at sublethal doses to enhance beauty spans the ages. The Botox injection is the fastest growing cosmetic procedure, and its physiologic safety profile is considered to be excellent. The psychosocial consequences of Botox have been largely ignored in the literature... CONCLUSIONS: The impact of Botox on the psychosocial functioning of individuals was investigated in this study from a psychosocial and clinical perspective in an effort to pave the way for the formulation of national standardized guidelines for the use of Botox. This study empowers the clinician to understand the basis for the relative contraindications of Botox, which are largely psychological in nature, and thus to ensure its administration in a safe and responsible manner.
Treatment of periorbital rhytids with botulinum toxin type A: maximizing safety and results. [2005.05]
Botulinum toxin type A is widely used for treatment of facial rhytids, often in an "off-label" fashion. Important mechanisms of action and safety concerns for such treatments are presented along with recommendations for treatment of periorbital rhytids..
Dose-ranging study of botulinum toxin type A in the treatment of glabellar rhytids in females. [2005.04]
OBJECTIVE: To compare the efficacy, safety, and duration of effect of four doses of botulinum toxin type A in the treatment of glabellar rhytids in females... CONCLUSION: Twenty to 40 U botulinum toxin type A doses were significantly more effective at reducing glabellar lines than 10 U. Most subjects experienced benefits for 3 to 4 months; some subjects demonstrated effect for up to 12 months.
Treatment of nasal wrinkles with botulinum toxin. [2005.03]
BACKGROUND: Nasal wrinkles on the dorsum of the nose can frequently be treated with botulinum toxin type A by injecting a few units into the nasalis muscle. Between 2 and 5 U of botulinum toxin have commonly been used. However, clinicians have observed that some nasal wrinkles persist following nasalis treatment. OBJECTIVE: To detail remaining nasal and perinasal rhytids and further injection sites, which can lead to improvement... CONCLUSION: Understanding nasal wrinkle patterns allows for complete wrinkle treatment of the nose beyond simple bilateral treatment of the nasalis. New points of botulinum toxin application improve not only wrinkles at the root of the nose but also wrinkles in the nasoalar area.
Double-blind, randomized, placebo-controlled, dose-response study of the safety and efficacy of botulinum toxin type A in subjects with crow's feet. [2005.03]
BACKGROUND: Published evidence suggests that botulinum toxin type A (BTX-A) is an effective treatment for crow's feet. However, few dose-ranging studies have been performed. OBJECTIVES: To assess the safety and efficacy of a single treatment with one of four doses of BTX-A (Botox/Vistabel, Allergan Inc) compared with placebo for the improvement of crow's feet... CONCLUSION: BTX-A is safe and effective in decreasing the severity of crow's feet, with 12 U per side suggested as the most appropriate dose.
The functional anatomy of the lower face as it applies to rejuvenation via chemodenervation. [2005.02]
Botulinum toxin type A (Botox) injections have revolutionized nonsurgical rejuvenation of the upper face since their introduction in the early 1990s. Their use in the lower face has not become nearly as popular... This is not an area for the novice injector, as a few stray units are not tolerated nearly so well as they are in the upper face.
Managing adverse events associated with botulinum toxin type A: a focus on cosmetic procedures. [2005.01]
Botulinum toxin A (BTXA) has become a widely used drug in cosmetic dermatology, not only to treat focal hyperhidrosis but also hyperkinetic facial lines, platysma bands, decollete bands, and other skin features. The spectrum of possible adverse effects of BTXA is broad but fortunately those that have been observed with cosmetic use of this product are generally mild and transient...
Dry eyes and superficial punctate keratitis: a complication of treatment of glabelar dynamic rhytides with botulinum exotoxin A. [2004.12]
BACKGROUND: Dry eyes and superficial punctate keratitis are potential complications of periocular botulinum exotoxin A treatment. OBJECTIVE: To report a patient who had these side effects after being treated with botulinum exotoxin A for glabelar rhytides and discuss possible causes including excessive paralysis of the orbicularis oculi leading to lagophthalmos and direct paralysis of the lacrimal gland... CONCLUSION: Paralytic lagophthalmos caused dry eyes and superficial punctate keratitis in our patient. To avoid this complication, if an injection is to be done in the lateral brow area, it should be done 1 cm above the orbital rim.
Consensus recommendations on the use of botulinum toxin type a in facial aesthetics. [2004.11]
The use of botulinum toxin type A for facial enhancement is the most common cosmetic procedure currently undertaken in the United States. Overall clinical and study experience with botulinum toxin type A treatment for facial enhancement has confirmed that it is effective and safe in both the short and long term...
Update on botulinum toxin use in facial plastic and head and neck surgery. [2004.08]
PURPOSE OF REVIEW: The purpose of this review is to discuss current trends in the medicinal use of botulinum toxin in head and neck and facial plastic surgery. The basic science of botulinum toxin is presented along with a comparison of the subtypes currently available on the market.The chronic use of botulinum toxin specifically for cosmetic purposes is worthy of additional study.
A multicenter, randomized, double-blind, placebo-controlled study of efficacy and safety of 3 doses of botulinum toxin A in the treatment of glabellar lines. [2004.08]
BACKGROUND: Botulinum toxin A (BTX-A) is used to treat glabellar lines but the rigorous demonstration of its efficacy in a well-designed study had never been reported. OBJECTIVE: This study was designed to evaluate the efficacy and the safety of 3 doses of BTX-A in the treatment of glabellar lines... CONCLUSION: BTX-A is an effective and safe treatment for glabellar lines.
Botox and collagen for glabellar furrows: advantages of combination therapy. [2004.05]
Plastic surgeons frequently administer botulinum toxin A (Botox) or collagen as monotherapy to treat glabellar furrows... By simultaneously addressing the static and dynamic aspects of glabellar furrows, dual therapy provides optimal treatment of this problem.
Dilution, storage, and electromyographic guidance in the use of botulinum toxins. [2004.04]
Botulinim toxin A (BTX-A) is available commercially in two formulations: Botox (Allergan, Inc.
Comparison of botulinum toxins A and B in the treatment of facial rhytides. [2004.04]
Facial rhytides of the upper one third of the face are common aesthetic concerns, and are caused principally by overactivity of the underlying facial musculature. Botulinum toxin, which acts by causing flaccid paralysis of facial mimetic muscles, has become a treatment of choice for the management of these hyperfunctional facial lines...
Botulinum toxin A in the mid and lower face and neck. [2004.04]
Botulinum toxins have been smoothing hyperkinetic lines in the upper face for over 15 years. More recently, their use has widened to include applications in the mid and lower face and neck to smooth, shape, and sculpt, blurring the line between science and art.
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