The use of botulinum toxin A (Botox; Allergan, Irvine, Calif.) for cosmetic purposes was first described in the medical literature in 1992. The author has been using botulinum toxin A in his practice for cosmetic purposes since 1991. In May of 1992, he began using Botox for improvement of the nasolabial folds. An experience of over 1000 injections to the nasolabial folds in more than 200 unique patients is presented. Technique and selection criteria have changed greatly during the past 10 years, and this evolution is discussed. The keys to achieving adequate correction and satisfied patients when treating the nasolabial fold are proper diagnosis of what is causing the fold and careful patient selection.
"The simultaneous use of BTX-A and fillers for lower facial applications is not an either–or proposition; rather, their conjunctive use is encouraged and it is where usage trends appear to be headed      . Specific areas in which BTX-A and fillers are commonly administered include the perioral lip line, oral commissures, and nasolabial folds   . "
[Show abstract][Hide abstract] ABSTRACT: 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. BTX-A, especially when used in combination with fillers, has generally proven to be safe and efficacious in these areas. For optimal results, however, several issues must be taken into considerations, including dosing differences versus upper facial applications, the specific type of botulinum toxin used and the importance of precise placement and injection technique. 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.
Facial Plastic Surgery Clinics of North America 03/2007; 15(1):41-9, vi. DOI:10.1016/j.fsc.2006.12.001 · 0.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: After cyclodextrin-coated 10−6m steroid hormone treatment for 3 days (hormonal imprinting), Tetrahymena cells and their media were analysed by radioimmunoassay for the same hormone and for the presence of the other two. In the absence of hormone treatment, the cells contained no detectable levels of the three steroids. By 2 days in fresh medium following exposure of cells to a 72h pretreatment of each specific hormone, correspondingly high quantities of hydrocortisone and oestradiol, but lesser quantities of testosterone, were found in both the media and the cells. One week after treatment only traces of hydrocortisone were found, exclusively within the cells themselves. Oestradiol was present in measurable quantities in both cells and media, whereas testosterone was only present in the medium. The presence of the other two hormones to the one used in the pretreatment were not usually present, except that when testosterone had been given, some oestradiol was also detected at 48h, suggesting Tetrahymena has a functional cytochrome P450aromatase.
Cell Biology International 01/1998; 22(11):875-878. DOI:10.1006/cbir.1998.0326 · 1.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The approach to facial rejuvenation continues to evolve. For decades, the primary focus on rejuvenation has centered on modalities such as skin care, skin resurfacing, soft-tissue augmentation, and surgical intervention. A better understanding of the physiologic changes that occur with facial aging lends itself to new approaches and techniques that are mindful of the causes. As animation has shown to be a significant contributor to both the appearance of facial lines and soft-tissue malposition, there has been recent interest in chemodenervating agents and their applications in the field of facial rejuvenation. These agents, by and large, efface rhytides by selective and precise focal paralysis of the underlying facial musculature and, therefore, reduce or eliminate the prominence of the overlying rhytides. In addition, chemodenervation can serve as an adjunct for facial rejuvenation because of its influence on facial soft-tissue position and shape. Botulinum toxin, derived from Clostridium botulinum, is the most widely used agent; therefore, this new modality, its applications in cosmetic plastic surgery, and its applications to other areas will be discussed.
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