The Role of Neurotoxins in the Periorbital and Midfacial Areas

Erickson, Benjamin P.; Lee, Wendy W.; Cohen, Joel L.; Grunebaum, Lisa D.

doi:10.1016/j.fsc.2015.01.010

Cited by 36 publications

(45 citation statements)

References 51 publications

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“…Theories of facial aging have largely focused on changes in skin, underlying fat, and bone that result in sagging and folds [1], while the role of muscle in aging has generally been neglected [2]. The complementary and distinct ways in which injectable fillers and neuromodulators have generally been used for rejuvenation and improvement of facial esthetics [3] illustrate how skin and fat are considered separately from muscle action.…”

Section: Introductionmentioning

confidence: 99%

Myomodulation with Injectable Fillers: An Innovative Approach to Addressing Facial Muscle Movement

Maio¹

2018

Aesth Plast Surg

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Consideration of facial muscle dynamics is underappreciated among clinicians who provide injectable filler treatment. Injectable fillers are customarily used to fill static wrinkles, folds, and localized areas of volume loss, whereas neuromodulators are used to address excessive muscle movement. However, a more comprehensive understanding of the role of muscle function in facial appearance, taking into account biomechanical concepts such as the balance of activity among synergistic and antagonistic muscle groups, is critical to restoring facial appearance to that of a typical youthful individual with facial esthetic treatments. Failure to fully understand the effects of loss of support (due to aging or congenital structural deficiency) on muscle stability and interaction can result in inadequate or inappropriate treatment, producing an unnatural appearance. This article outlines these concepts to provide an innovative framework for an understanding of the role of muscle movement on facial appearance and presents cases that illustrate how modulation of muscle movement with injectable fillers can address structural deficiencies, rebalance abnormal muscle activity, and restore facial appearance.Level of Evidence VThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Section: Introductionmentioning

confidence: 99%

Myomodulation with Injectable Fillers: An Innovative Approach to Addressing Facial Muscle Movement

Maio¹

2018

Aesth Plast Surg

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“…Approved by the US FDA in 1989 for strabismus and blepharospasm, cosmetic purposes were included a decade later 40. However, the treatment effect is temporary, and not exempt from complications 41.…”

Section: Resultsmentioning

confidence: 99%

Non-surgical treatment for eyelid retraction in thyroid eye disease (TED)

et al. 2017

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Thyroid eye disease (TED) is an autoimmune condition with an unpredictable course that may lead to permanent facial disfigurement. Eyelid retraction is one of the most common findings, and frequently demands attention due to ocular exposure and impaired cosmesis. Surgical treatment remains the most effective option, but there is a role for temporary corrections during the active phase of the disease, as well as in patients who are poor surgical candidates. The aim of this review is to describe the non-surgical modalities currently available for treatment of eyelid malposition in TED. The authors have focused on the use of hyaluronic acid, triamcinolone injections and botulinum toxin type A as non-surgical treatment alternatives, paying special attention to dosing, technique, efficacy and duration of effect. Non-surgical treatment modalities may represent viable in cases where surgical correction is not an option. Although temporary, these modalities appear to be beneficial for ocular exposure remediation, improving quality of life and broadening our therapeutic arsenal.

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“…In clinical practice, it is recommended to apply Botox or Dysport at a ratio of 1:2.5-3 units (U). 10,11 This dosage was determined based on safety rather than efficacy. 12 One U of Botox is equivalent to 1 U of Xeomin and 50-100 U of Myobloc.…”

Section: Introductionmentioning

confidence: 99%

“…4,6,10,11 BoNT-A preparations are distributed in the form of vials containing lyophilized powder. A Botox vial containing 100 U of BoNT-A is reconstituted with 1-8 mL of sterile saline.…”

Section: Introductionmentioning

confidence: 99%

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Use of Botulinum Neurotoxin in Ophthalmology

Başar

Arıcı

2016

tjo

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Botulinum neurotoxin (BoNT) is the first biological toxin used in the treatment of ophthalmic diseases and to decrease skin wrinkles as an aesthetic agent. When used appropriately, it weakens the force of muscular contraction and/or inhibits glandular secretion. The most common areas for botulinum toxin treatment are the upper face, including the glabella, forehead, brows, and lateral canthal lines, or crow’s feet. By relaxing the muscles causing wrinkles, non-permanent results may be achieved with its use. BoNT has gained widespread use in a variety of ophthalmic diseases. The effect of BoNT is temporary, but the therapeutic benefit is usually maintained even after repeated injections. Treatment is usually well tolerated. Complications and side effects associated with the treatment are rare and temporary. Complications occur due to weakness (chemodenervation) of adjacent muscle groups, immunological mechanisms and injection technique. Current therapeutic indications, doses, complications and contraindications of BoNT use in the following disorders related to ophthalmology were investigated: aesthetic use, strabismus, blepharospasm, hemifacial spasm, eyelid retraction, entropion, lacrimal hypersecretion syndrome, and facial paralysis.

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The Role of Neurotoxins in the Periorbital and Midfacial Areas

Cited by 36 publications

References 51 publications

Myomodulation with Injectable Fillers: An Innovative Approach to Addressing Facial Muscle Movement

Myomodulation with Injectable Fillers: An Innovative Approach to Addressing Facial Muscle Movement

Non-surgical treatment for eyelid retraction in thyroid eye disease (TED)

Use of Botulinum Neurotoxin in Ophthalmology

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