-
Diseases (Basel, Switzerland) Sep 2022Facial hemiplegia happens when the seventh cranial nerve is inflamed, causing a dysfunction of the facial nerve in specific regions. This case report brings a complex...
Facial hemiplegia happens when the seventh cranial nerve is inflamed, causing a dysfunction of the facial nerve in specific regions. This case report brings a complex case of facial hemiplegia, a non-temporary lesion caused by a traumatic accident, which had a more conservative approach, treating the patient with botulinum toxin. After explanation of treatment outcomes, the patient favored treatment on a unilateral side with botulinum toxin applied locally to the muscles. It was applied on her left side, in order to change the muscles tonus and improve the esthetic. The patient adhered to immediate and short-term instructions following the procedure, including movement limitation and skin exposure avoidance. At 2 weeks, the patient returned to follow-up, and the result was checked. After around 6-month follow-up, the patient was reassessed, and a new application was done. The patient tried to contract the procerus and corrugator muscles which were treated, and periorbicular region that was corrected. After contracting the frontal muscle, a satisfactory result was also seen in the frontal area. While limited to a single case presentation, botulinum toxin may be an effective short-term tool for treatment of facial hemiplegia to establish an effective esthetic result.
PubMed: 36278566
DOI: 10.3390/diseases10040067 -
Journal of Plastic, Reconstructive &... Sep 2022The primary goal of blepharoplasty for blepharoptosis and blepharochalasis is to elevate the upper eyelid to restore a full field of vision, although many surgeons also...
INTRODUCTION
The primary goal of blepharoplasty for blepharoptosis and blepharochalasis is to elevate the upper eyelid to restore a full field of vision, although many surgeons also aim to provide a better aesthetic outcome. Several facial configuration changes may occur following blepharoplasty. This study examined the effectiveness of vessel clips to preoperatively predict facial configuration alterations.
METHODS
We retrospectively enrolled 93 consecutive patients who underwent blepharoplasty correction for blepharoptosis and blepharochalasis with eyebrow elevation. Frontal portrait images were taken at the initial examination without load, preoperatively with vessel clips, and without load at 6 months postoperatively for evaluations of eyebrow height, forehead wrinkle length, and procerus area wrinkle length. Subjective outcomes were also surveyed by questionnaires and interviews at 6 months post-surgically.
RESULTS
No significant differences were detected between preoperative measurements with vessel clips and recordings at 6 months postoperatively. Significant correlations were identified among the addition/reduction values for preoperative and postoperative measurements (eyebrow height and forehead wrinkle length: r=0.402, p<0.001; eyebrow height and procerus area wrinkle length: r=-0.327, p<0.01; forehead wrinkle length and procerus area wrinkle length: r=-0.488, p<0.001). Women more frequently described notable changes in wrinkles than men.
CONCLUSIONS
Postoperative facial change outcomes for blepharoplasty may be predicted using the simple but effective vessel clip test. A better understanding of surgical results can relieve patient anxiety and contribute to increased satisfaction.
Topics: Blepharoplasty; Blepharoptosis; Eyebrows; Eyelids; Female; Humans; Male; Retrospective Studies
PubMed: 35752591
DOI: 10.1016/j.bjps.2022.04.066 -
Toxins May 2022Botulinum neurotoxin injection surrounding the nose area is frequently used in aesthetic settings. However, there is a shortage of thorough anatomical understanding that... (Review)
Review
Botulinum neurotoxin injection surrounding the nose area is frequently used in aesthetic settings. However, there is a shortage of thorough anatomical understanding that makes it difficult to treat wrinkles in the nose area. In this study, the anatomical aspects concerning the injection of botulinum neurotoxin into the nasalis, procerus, and levator labii superioris alaeque muscles are assessed. In addition, the present knowledge on localizing the botulinum neurotoxin injection point from a newer anatomy study is assessed. It was observed that, for the line-associated muscles in the nose region, the injection point may be more precisely defined. The optimal injection sites are the nasalis, procerus, and levator labii superioris alaeque muscles, and the injection technique is advised. We advise the best possible injection sites in association with anatomical standards for commonly injected muscles to increase efficiency in the nose region by removing the wrinkles. Similarly, these suggestions support a more precise procedure.
Topics: Botulinum Toxins; Facial Muscles; Injections; Nose; Skin Aging
PubMed: 35622589
DOI: 10.3390/toxins14050342 -
Facial Plastic Surgery Clinics of North... May 2022Nonsurgical rhinoplasty procedures using soft tissue fillers have gained popularity. With the increasing frequency of such procedures, the incidence of intra-arterial... (Review)
Review
Nonsurgical rhinoplasty procedures using soft tissue fillers have gained popularity. With the increasing frequency of such procedures, the incidence of intra-arterial injection of soft tissue filler material and subsequent ischemia has also risen. This article analyzes the topographic anatomy of the dorsal nasal artery in the nasal soft tissue to potentially enhance patient safety in nonsurgical rhinoplasty procedures. The dorsal nasal artery shows a variable topographic course, especially in relationship to the procerus muscle. By understanding the topographic courses of the dorsal nasal artery, aesthetic practitioners may be able to perform nonsurgical rhinoplasty procedures with increased safety and efficacy.
Topics: Arteries; Esthetics; Humans; Nose; Rhinoplasty
PubMed: 35501050
DOI: 10.1016/j.fsc.2022.01.002 -
Journal of Cosmetic Dermatology Jun 2022Injection of botulinum toxin for cosmetic purposes is a well-established practice. (Randomized Controlled Trial)
Randomized Controlled Trial
Evaluation of the safety and efficacy of a biosimilar abobotulinum toxin type A in treating moderate-to-severe glabellar lines: A non-inferiority double blinded randomized controlled trial.
BACKGROUND
Injection of botulinum toxin for cosmetic purposes is a well-established practice.
OBJECTIVES
This study was conducted to compare the safety and efficacy of Dyston (investigational biosimilar abobotulinumtoxinA) with Dysport (abobotulinumtoxinA, Ipsen) in the treatment of moderate-to-severe glabellar lines.
METHODS
Out of 193 screened subjects, 126 volunteers with moderate-to-severe glabellar lines fulfilling eligibility criteria were randomized in a 1:1 ratio to receive either an intramuscular injection of 40-60 units of Dyston or Dysport . The primary objective was to test the non-inferiority of Dyston compared with Dysport as measured by the percentage of volunteers who achieved no or mild glabellar lines at maximum frown assessed by the physicians based on the Glabellar Line Severity Score (GLSS) at Day 30. Secondary endpoints included the improvement in the glabellar lines at maximum frown and rest states at Days 14, 60, 90, and 120 as well as the side effects of the treatment.
RESULTS
Response rates at maximum frown were 75.44% (43/57) in the Dyston group and 76.67% (46/60) in the Dysport group on Day 30 (p value: 0.88, 95% CI: -14.24 to 16.70, diff: 1.23) as per-protocol set, and were 75.81% (47/62) and 76.19 (48/63) (p value: 0.96, 95% CI: -14.59 to 15.35, diff: 0.3) in the Dyston and the Dysport groups, respectively, based on modified intention to treat population. Adverse events were similar in both groups and mostly mild and well-tolerated.
CONCLUSION
Treatment of moderate-to-severe glabellar lines with Dyston was effective, tolerable, and non-inferior compared with Dysport .
Topics: Biosimilar Pharmaceuticals; Botulinum Toxins, Type A; Double-Blind Method; Forehead; Humans; Neuromuscular Agents; Skin Aging; Treatment Outcome
PubMed: 35340107
DOI: 10.1111/jocd.14939 -
Journal of Cosmetic Dermatology Apr 2022When applying botulinum toxin in the upper third of the face, it is important to consider the balance between the elevator and depressor muscles of the eyebrows.... (Review)
Review
INTRODUCTION
When applying botulinum toxin in the upper third of the face, it is important to consider the balance between the elevator and depressor muscles of the eyebrows. Depressor supercilii muscle block leads to elevation of the medial portion of the eyebrow and correction of the oblique lines in the frown.
OBJECTIVES
The intention is to highlight the importance of the depressor supercilii muscle block as a useful tool to reposition the medial portion of the eyebrow.
PATIENTS AND METHODS
Three cases are presented, in whom botulinum toxin is applied conventionally and subsequently on the depressor supercilii muscle after the subjective sensation of flattening of the glabella and increasing distance between the eyebrows referred by the patients.
RESULTS
The application of botulinum toxin type A on the depressor supercilii muscle is an effective measure to facilitate the elevation of the medial portion of the eyebrow, after the conventional application in between the eyebrows treating the orbicularis, corrugator, and procerus muscles.
CONCLUSIONS
Depressor supercilii muscle block can be considered when applying botulinum toxin type A in the upper third of the face, in cases where there is loss of facial aesthetic harmony. This is given by the subjective perspective of the patient due to a change in the natural expression of their face with a sensation of flattening of the glabella and distancing of the medial portion of the eyebrows, occurring after the use of a conventional technique at that anatomical level, where patients may report a "feline" or "avatar" appearance.
Topics: Botulinum Toxins, Type A; Esthetics; Eyebrows; Facial Muscles; Forehead; Humans
PubMed: 35175677
DOI: 10.1111/jocd.14856 -
Toxins Dec 2021When botulinum neurotoxin (BoNT) is injected to treat glabellar frown lines, the corrugator supercilia muscle (CSM) and procerus muscles are the main targets. Although...
When botulinum neurotoxin (BoNT) is injected to treat glabellar frown lines, the corrugator supercilia muscle (CSM) and procerus muscles are the main targets. Although there have been many studies on the treatment of glabellar frown lines, no study has confirmed the dynamic movement under ultrasonography (US). This study examined and evaluated dynamic muscle movements under US, thereby providing more effective BoNT injection guidelines for glabellar frowning. Glabellar frowning was categorized as either Type A or B. Type A is the general frowning pattern in which vertical wrinkles are made by contracting the CSM and procerus muscles (81%, = 13). On US images, the procerus muscle thickens and the bilateral CSMs contract. Type B is an upward frowning pattern demonstrating upward elevation of vertical wrinkles due to hyperactive contraction of the frontalis muscle during frowning (19%, = 3). On US images, the hypoechoic frontalis muscle thickens, forming horizontal forehead lines. After BoNT injection into the CSM and frontalis muscle but not the procerus muscle, Type B patterns showed improvements in the vertical crease and horizontal forehead line. Both types showed improvement in glabellar frown lines after conventional injection, but the horizontal forehead line did not improve in Type B. Type B wrinkles improved after additional injections into the frontalis muscle. This study provided novel anatomical findings related to the injection of glabellar frown lines with BoNT. Preliminary analysis and optimized procedures using US will enable more effective and safer injections.
Topics: Adult; Botulinum Toxins; Face; Facial Muscles; Female; Humans; Injections; Male; Neuromuscular Agents; Republic of Korea; Skin Aging; Ultrasonography; United States; Young Adult
PubMed: 35050994
DOI: 10.3390/toxins14010017 -
Journal of Cosmetic Dermatology Jan 2022The human face significantly affects the individuals' quality of life, attitude, and mental state. The study of anatomy would always be on the spotlight, as the beauty...
BACKGROUND
The human face significantly affects the individuals' quality of life, attitude, and mental state. The study of anatomy would always be on the spotlight, as the beauty of the face is desired by humans worldwide. However, age, stress, and negative emotions could lead to stimulation of the corrugator supercilii and procerus muscles in the glabellar region and, subsequently, to alterations in face's characteristics, which could be associated with isolation and avoidance of engaging in social contacts.
AIMS
Here, we aimed to examine the degree to which treatment with botulinum toxin type A (BoNT A) can affect patients' quality of life and mental state.
PATIENTS/METHODS
The data collection was performed using 11 questionnaires, which were filled by 83 individuals who underwent BoNT A treatment (sex, 95% female and 5% male; mean age, 48 years).
RESULTS
The results showed that the treatment with BoNT A improved the patients' social and psychological behavior, and their opinion regarding their appearance. This effect developed within 1 month following completion of the treatment. Moreover, the effect was higher in patients' social behavior and was better in patients aged 40-49 years compared to those aged <40 and ≥49 years.
CONCLUSIONS
Thus, BoNT A treatment could be considered as an important way to improve the social behavior and socialization of individuals by raising their psychology and self-esteem.
Topics: Botulinum Toxins, Type A; Facial Muscles; Female; Humans; Male; Mental Health; Middle Aged; Neuromuscular Agents; Quality of Life; Retrospective Studies; Social Behavior
PubMed: 34806297
DOI: 10.1111/jocd.14627 -
Aesthetic Plastic Surgery Feb 2022
Invited Discussion on: Can Procerus Transection Alter the Radix Morphology and Influence the Nasal Length? A Study of Photogrammetric Assessments and Anthropometric Measurements on Asian Patients.
Topics: Facial Muscles; Humans; Nose; Photogrammetry
PubMed: 34580761
DOI: 10.1007/s00266-021-02495-x -
Aesthetic Plastic Surgery Feb 2022The procerus is the main muscle across the radix that needs to be operated during rhytidectomy, however, it is unclear whether transecting it can morphologically affect...
Can Procerus Transection Alter the Radix Morphology and Influence the Nasal Length? A Study of Photogrammetric Assessments and Anthropometric Measurements on Asian Patients.
BACKGROUND
The procerus is the main muscle across the radix that needs to be operated during rhytidectomy, however, it is unclear whether transecting it can morphologically affect the nose.
METHODS
A retrospective study of Asian patients who underwent procerus transection during rhytidectomy in our single institution was performed to assess whether the radix profile had any change postoperatively. The procerus was transected at a plane above the nasion.
RESULTS
Ninety-four patients were included. All of them were female with an average age of 50.7 ± 5.2 years and a mean follow-up time of 7.8 ± 3.2 months. Twenty-seven (28.7%) had moderate horizontal wrinkles preoperatively, and sixty-seven (71.3%) had severe rhytides. Different degrees of wrinkle improvement were seen on 91 (96.8%) patients, and no improvement occurred to 3 (3.2%) patients after procerus transection. The anthropometric measurements on these patients did not find any significant difference between the preoperative and postoperative nasal heights, radix projections, nasal lengths, or nasofrontal angles (all p >0.05).
CONCLUSIONS
Procerus transection primary contributes to wrinkle improvement. The morphological change of the radix following this operation is too subtle to be observed. This conclusion should be further verified on large samples as well as on other ethnic cohorts in a long-term follow-up.
LEVEL OF EVIDENCE IV
This journal requires that authors 10 assign a level of evidence to each article. For a full 11 description of these Evidence-Based Medicine ratings, 12 please refer to the Table of Contents or the online 13 Instructions to Authors www.springer.com/00266 .
Topics: Anthropometry; Asian People; Facial Muscles; Female; Humans; Middle Aged; Nose; Photogrammetry; Retrospective Studies; Treatment Outcome
PubMed: 34491414
DOI: 10.1007/s00266-021-02435-9