Resistance to Botulinum Toxin in Aesthetics

Abstract

Botulinum toxins are widely used worldwide for the treatment of medical and esthetic disorders. They are considered the gold standard for the treatment of muscular spasticity and facial dynamic wrinkles. Moreover, they are a valid alternative in the treatment of pain and hyperhidrosis. Several adverse events to their applications have been described, being the most frequent hematomas, migraines, palpebral ptosis, ectropion, or lack of response. Resistance to botulinum toxins in the medical field has been described, at higher dosages and short intervals. Nevertheless, resistance to botulinum toxin in esthetics has been considered traditionally anecdotic. Recent evidence suggests that resistance to botulinum toxins in esthetics may have higher prevalence than expected. A full analysis of the argument is given with up dated information regarding botulinum toxin resistance in medical and esthetic arenas; including elements for suspicion and diagnosis, valid alternatives for effective prevention, education and treatment of this misdiagnosed condition.

Remodeling of facial soft tissue induced by simultaneous application of HIFES and synchronized radiofrequency provides nonsurgical lift of facial soft tissues

“…In addition, invasive procedures may cause scarring, and neurotoxin overuse may build up a resistance to active substances. 24 On the contrary, noninvasive treatment by RF and HIFES avoids any downtime or unpleasant risks, as documented in this study.…”

“…Although the concurrent approaches possess high efficiency, the long recovery period, non‐negligible risk of adverse effects, and lesser comfort level may not be acceptable for all patients. In addition, invasive procedures may cause scarring, and neurotoxin overuse may build up a resistance to active substances 24 . On the contrary, noninvasive treatment by RF and HIFES avoids any downtime or unpleasant risks, as documented in this study.…”