The effect of botulinum toxin injections on the nasolabial fold.
ABSTRACT 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.
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ABSTRACT: Wrinkle formation usually accompanies skin aging. In particular, accentuated nasolabial folds and loss of elasticity are early signs of skin aging. The use of 1,444-nm pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers has increased in popularity. To evaluate the safety and efficacy of a novel 1,444-nm pulsed Nd:YAG laser in the treatment of NLF and cheek laxity using subdermal laser therapy. Ten Korean patients with moderate to severe NLF were enrolled. Each received a single treatment session with a 1,444-nm Nd:YAG laser. Two blinded physicians evaluated clinical improvement by rating comparative photographs on a 5-point scale. Efficacy was also assessed by measuring elasticity and roughness. Skin biopsies were performed on five volunteers before treatment and 3 months after treatment. The 1,444-nm Nd:YAG laser effectively promoted clinical improvement of NLF and cheek laxity (p < .05). Significant differences in elasticity and roughness were observed (p < .05). Epidermal proliferation was stimulated as demonstrated by increases in epidermal thickness and Ki-67 expression (p < .05). Quantitative image analyses of pre- and post-treatment biopsies revealed that collagen fibers increased from baseline (p > .05). Transforming growth factor beta and heat shock protein-70 messenger RNA levels quantified using real-time reverse transcriptase polymerase chain reaction increased significantly from baseline (p < .05). The 1,444-nm Nd:YAG laser is an effective treatment modality with minimal complications for the treatment of NLF and cheek laxity, but further research with a larger group of patients is needed to confirm these findings.Dermatologic Surgery 07/2013; 39(7):1067-78. · 1.87 Impact Factor
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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. · 1.64 Impact Factor
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ABSTRACT: Background: Due to advances in detection and treatment, approximately 70 percent of cancer patients are living more than five years after diagnosis. Research indicates that appearance worries are of great concern to cancer survivors impacting their quality of life. This is the first Phase IV investigator-initiated study to investigate the safety and efficacy of facial rejuvenation with small gel particle hyaluronic acid with lidocaine and abobotulinumtoxinA in post-chemotherapy patients. Methods: The safety and efficacy of facial rejuvenation with small gel particle hyaluronic acid with lidocaine and abobotulinumtoxinA was assessed in nine post-chemotherapy patients. Efficacy of small gel particle hyaluronic acid with lidocaine and abobotulinumtoxinA was measured at baseline, Week 2, and Week 8, using a wrinkle severity assessment score. Safety and tolerability of both products were assessed throughout the study by monitoring the occurrence of adverse events. Results: Patients received a mean total of 2.4mL of small gel particle hyaluronic acid with lidocaine in the nasolabial folds and 57.8 Units of abobotulinumtoxinA to glabellar lines at baseline. Additionally, at Week 2, a mean total l.OmL of small gel particle hyaluronic acid with lidocaine was administered to four patients. The mean investigator's wrinkle severity assessment score at baseline was 2.22, indicating mild-to-moderate severity. At each of Weeks 2 and 8, there were significant improvements from baseline in wrinkle severity (p=0.004). Overall, small gel particle hyaluronic acid with lidocaine was well tolerated. Adverse events (i.e., bruising, redness, swelling, pain, tenderness, itching or other adverse events) were localized, self-limiting, and resolved within 1 to 2 days. The only adverse event attributed to abobotulinumtoxinA was soreness and slight tenderness at an injection site reported in one patient. Conclusion: Both study products were well tolerated in post-chemotherapy patients with no significant adverse events. There was a clinically meaningful and statistically significant improvement in wrinkle severity at Week 2 post-administration as compared to baseline. This improvement was maintained in all patients at Week 8.Journal of Clinical and Aesthetic Dermatology 01/2014; 7(1):31-6.