Botulinum Toxin Procedures in Cosmetic Dermatology Series

Title Page
Table of Contents
Series page
Copyright
Video contents
Series preface
Series preface first edition
Preface
List of contributors
Acknowledgments
Dedication
1 Therapeutic uses of the botulinum toxins
	Introduction
	Hyperfunctional muscular uses
	Autonomic nervous system use
	Afferent nervous system, pain syndromes, and antiinflammatory
	Further reading
2 History of onabotulinumtoxinA therapeutic
	Introduction
	Identification, isolation, and characterization
	Exploration of clinical potential
	Developed indications for onabotulinumtoxinA
	Commentary
	Acknowledgment
	Further reading
3 History of cosmetic botulinum toxin
	Introduction
	Serendipitous discovery
	Patient zero and the first clinical trials
	FDA approval
	The face of BoNT
	Further reading
4 Basic science of BOTOX® Cosmetic
	Introduction
	Serotypes and structure
	Role of neurotoxin-associated proteins
	Manufacturing
	Formulation
	Mechanism of action
	Immunogenicity
	Clinical pharmacology of onabotulinumtoxinA in aesthetics
	Approvals
	Exploration of potential new uses in dermatology
	Unique dosing of neuromodulators
	Summary and conclusions
	Acknowledgment
	References
	Further reading
5 AbobotulinumtoxinA
	Clinical studies performed for abobotulinumtoxinA
	References
	Further reading
6 Basic science
	Introduction
	Properties of incobotulinumtoxinA
	Clinical performance of incobotulinumtoxinA
	Clinical experience with incobotulinumtoxinA
	Conclusion
	References
	Further reading
7 Basic science
	Introduction
	Mechanism of action
	Myobloc formulation and dosage
	Immunogenicity of Myobloc
	Clinical studies in aesthetic medicine
	Side effects
	Conclusion—future outlook
	References
8 Neuronox® and Innotox®
	Introduction
	Microbiological, physicochemical, and biochemical profiles of Neuronox®
	Innotox®: novel liquid botulinum toxin type A product
	Use of Neuronox® and Innotox® in Asians
	Further reading
9 Injectable daxibotulinumtoxinA (RT002)
	References
10 Comparison of botulinum toxins
	Introduction
	Types of botulinum toxin A
	Mechanism of action
	Compositional differences
	Dosing
	Efficacy
	Duration of action
	Diffusion and field of effect
	Safety
	Resistance
	Storage
	Conclusion
	Further reading
11 Topical daxibotulinumtoxinA (RT001)
	The need for topical delivery
	Topical daxibotulinumtoxinA
	Topical daxibotulinumtoxinA for lateral canthal lines
	Topical daxibotulinumtoxinA for hyperhidrosis
	Topical daxibotulinumtoxinA for migraine
	Further reading
12 Topical botulinum toxin type A
	Introduction
	Barriers to transdermal permeation
	Nanoemulsion delivery systems
	Allergan botulinum toxin type A topical nanoparticle delivery system
	Conclusions
	Further reading
13 Reconstitution and dilution
	Introduction
	Reconstitution diluents
	Foam, shaking, and stirring
	After reconstitution: storage, use, and sterility
	Fresh or frozen? Does it matter?
	What concentration is adequate for cosmetic and noncosmetic indication?
	Conclusion
	Further reading
14 Benzyl alcohol
	Introduction
	Saline with benzyl alcohol: early evidence of anesthetic efficacy and historical concerns
	Saline with benzyl alcohol: RCTs with botulinum toxin
	Saline with benzyl alcohol: use in combination with lidocaine infiltration
	Saline with benzyl alcohol: use in comparison with lidocaine infiltration
	Safety of saline with benzyl alcohol
	Summary of key concepts
	References
15 Glabella
	Introduction
	Anatomy
	Injection technique (see Video 15.1 “Botulinum Toxin Glabella”)
	Dosing
	Novel botulinum neurotoxins
	Special considerations
	Potential adverse events
	Conclusion
	Further reading
16 Modulation of eyebrow position and shape by treatment with Neuromodulators and fillers
	Introduction
	The consultation
	Treatment
	Fillers
	References
17 Frontalis and horizontal forehead line
	Introduction
	Side effects
	Injection techniques
	Types of botox
	Botox dosing
	Treatment of scars
	Conclusion
	Further reading
18 Treatment of crow's feet
	Introduction
	Anatomy of crow's feet lateral orbital rhytides
	The youthful eye
	The aging eye
	Preoperative assessment
	Treatment
	Adjunctive treatments
	Complications
	Conclusion
	Further reading
19 Infraorbital/upper and lower eyelids
	Introduction
	Anatomy of the eye
	Periorbital aging
	Patient assessment and selection
	Indications and techniques
	General considerations
	Adjunctive treatments for the lid
	Adverse events
	Conclusion
	Further reading
20 Treatment of the midface with botulinum toxin
	Introduction
	“Bunny” and nasal sidewall scrunch lines
	Levator labii superioris alaeque nasi
	Zygomaticus complex
	Risorius
	Conclusion
	Further reading
21 Orbicularis oris, mentalis, and depressor anguli oris
	Introduction
	Anatomy
	Perioral and chin aging
	Differences in the use of botulinum toxin for the upper and lower face
	Patient selection for botulinum toxin perioral and chin rejuvenation
	Target muscle
	Dosage and injection technique
	Conclusion
	Further reading
22 Platysma, Nefertiti lift, and beyond
	Introduction
	Anatomy
	Treatment techniques
	Technical variations for lower face contour with neuromodulators
	References
23 The masseters and their treatment with botulinum toxin
	Introduction
	History
	Anatomy
	Raison d’être for botulinum injection to the masseters
	Bruxism
	Treatment method
	Complications
	Conclusion
	References
	Further reading
24 Darker skin types
	Introduction
	Racial and ethnic differences in photoaging
	Safety and efficacy of botulinum toxins in darker skin types
	Ethnic specific applications of botulinum toxin
	Conclusion
	Further reading
25 Combination noninvasive facial aesthetic treatments with botulinum toxin type A
	Anatomy related to multiple therapeutic modalities
	Combination therapy in the upper face
	Brow ptosis
	Combination therapy in the lower face
	Neocollagenesis
	Injectables
	Skin tightening
	Vascular lesions and pigmentation
	Topical agents
	Sequence and timing of a multimodal approach
	Summary
	References
	Further reading
26 Focal axillary hyperhidrosis
	Introduction
	Epidemiology
	Quality of life
	Clinical assessment of hyperhidrosis
	Botulinum toxin therapy
	Axillary hyperhidrosis
	Use of botulinum toxin type B for hyperhidrosis
	Techniques for nonaxillary hyperhidrosis
	Future directions
	Further reading
27 Palmoplantar hyperhidrosis
	Introduction
	Patient evaluation
	General considerations
	Marking the treatment areas
	Anesthesia
	Dilution and injection
	Injection technique
	Results and follow-up
	Complications
	Conclusion
	Further reading
28 The future of neuromodulators in aesthetic medicine
	Introduction
	Expansion of current uses
	Changes to the molecule and formulation
	New areas and new uses
	Conclusions
	References
	Further reading
Index