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Toxins Jul 2023The present study aimed to evaluate the influence of physical activity on the durability of the esthetic effect of botulinum toxin type A (BoNT-A). Sixty female patients...
The present study aimed to evaluate the influence of physical activity on the durability of the esthetic effect of botulinum toxin type A (BoNT-A). Sixty female patients were allocated to three groups ( = 20) according to their physical activity level (PA): Low PA, Moderate PA, and High PA. All groups received a single injection of onabotulinumtoxinA, considering standardized doses in the frontalis (12U), corrugator supercilia (7U, each), and procerus muscles (4U). Outcomes were measured using electromyography (EMG), Merz 5-point scales, and Face-Q scales (perceived age and lines between eyebrows). A follow-up occurred after 30, 60, and 90 days. EMG results showed a significant decrease in muscle activity in the Low-PA group at all follow-ups compared with the other groups ( < 0.001). The Merz scale scores showed that the severity of forehead and glabellar lines significantly improved in the Low-PA group throughout this study compared with the other groups ( < 0.001). No significant differences between groups were found in the Face-Q scale for perceived age, while the Face-Q scale for lines between eyebrows showed better results for Low-PA ( < 0.01) and Moderate-PA ( < 0.01) groups compared to the High-PA group at the 30- and 90-day follow-ups. The durability of the esthetic effect of BoNT-A seems to be negatively influenced by the level of physical activity.
Topics: Humans; Female; Botulinum Toxins, Type A; Neuromuscular Agents; Single-Blind Method; Skin Aging; Exercise; Treatment Outcome
PubMed: 37505732
DOI: 10.3390/toxins15070463 -
Aesthetic Surgery Journal Nov 2023Precise injection technique is vital for avoiding suboptimal eyebrow position when treating glabellar lines with botulinum toxin type A.
BACKGROUND
Precise injection technique is vital for avoiding suboptimal eyebrow position when treating glabellar lines with botulinum toxin type A.
OBJECTIVES
The aim of this study was to evaluate the impact of glabellar injection technique on eyebrow position in patients treated with DaxibotulinumtoxinA for Injection (DAXI).
METHODS
This retrospective post hoc analysis involved 60 adults who received a single treatment with DAXI 40 U to the glabella and had standardized facial photography. Median vertical and horizontal displacement of the brows (at rest) at baseline and 2 weeks after glabellar injection were measured. Brow position outcomes were evaluated by an oculoplastic surgeon and expert anatomist. Investigators were interviewed to ascertain individual injection techniques.
RESULTS
Precise injection location and depth, and median resting brow position following treatment varied between investigators. Positive brow outcomes were achieved with deep DAXI injections into the medial corrugator, superficial lateral corrugator injections placed between the midpupil and lateral limbus, and deep midline procerus injections. Glabellar injection technique that more precisely targeted the corrugator muscles resulted in longer glabellar line treatment duration compared to a less targeted technique. Medial corrugator injections above the medial brow; lateral corrugator injections administered deeply or more medially, toward the medial third of the brow; and procerus injections superior to the inferomedial brow tended to be associated with suboptimal outcomes that were more apparent during dynamic expression.
CONCLUSIONS
Aesthetically pleasing brow outcomes and greater duration of efficacy can be achieved with an injection pattern that precisely treats the anatomic location of the corrugator supercilii and procerus muscles, avoiding the frontalis.
Topics: Adult; Humans; Botulinum Toxins, Type A; Retrospective Studies; Skin Aging; Injections; Rhytidoplasty; Forehead; Neuromuscular Agents
PubMed: 36322141
DOI: 10.1093/asj/sjac002 -
Journal of Clinical Movement Disorders 2014To provide a systematic description of component movements of upper facial chorea in Huntington disease, consecutive videos of 25 active patients with confirmed...
To provide a systematic description of component movements of upper facial chorea in Huntington disease, consecutive videos of 25 active patients with confirmed diagnosis were scored on eye opening, eye closing, and procerus/corrugator contractions. Of the 25 patients evaluated, 76% exhibited intermittently widened palpebral fissures associated with frontalis contractions. Brief periods of repetitive but irregular blinking were observed in 16%. 8% had brief spasms of the orbital portion of the orbicularis oculi muscles. In addition, brief contractions of procerus and corrugator supercilii muscles were noted in 52%.
PubMed: 26788333
DOI: 10.1186/2054-7072-1-7 -
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 -
Internal Medicine (Tokyo, Japan) Dec 2002
Topics: Aged; Brain Diseases; Facial Muscles; Facies; Female; Humans; Neurologic Examination; Supranuclear Palsy, Progressive
PubMed: 12521196
DOI: 10.2169/internalmedicine.41.1101 -
Clinical, Cosmetic and Investigational... 2021Botulinum toxin type A is an effective treatment for glabellar dynamic wrinkles. As the muscular group involved in the contraction of the glabella varies among people,...
PURPOSE
Botulinum toxin type A is an effective treatment for glabellar dynamic wrinkles. As the muscular group involved in the contraction of the glabella varies among people, individualized treatment can achieve optimal results. This study evaluates a customized assessment for the treatment of glabellar lines with Incobotulinumtoxin-A, leading to an individualized points distribution and dosage.
PATIENTS AND METHODS
A single-center, evaluator-blinded, therapeutic cohort study enrolled 130 women with moderate or severe glabellar wrinkles. They underwent Incobotulinumtoxin-A injection following the standard 5-point injection at the glabellar muscles (n = 65) or an individualized assessment and scheme treatment based on anatomical references of contraction, the One21 technique (n = 65). All the patients were photographed under maximum contraction before treatment (T0) and after 4 weeks (T28). The photos were randomly assessed by two blinded, experienced raters to consensually grade the severity according to the Merz Aesthetics Scales (MAS). The primary clinical efficacy was defined as a 2-point reduction in the MAS score, on Day 28.
RESULTS
The groups were homogeneous regarding age, phototype, and baseline MAS scores. On Day 28 (T28), 64 (98.5%) patients from the One21 group and 52 (80%) from the 5-point group reduced the MAS score by at least two points ( < 0.01). When adjusted by age and phototype, both groups reduced the MAS score at T28 ( < 0.01); nevertheless, patients from the One21 group significantly performed better ( < 0.01), with a much higher rate response rate at T28, in comparison to the 5-point group. Of patients enrolled in the 5-point group, 83.1% utilized muscle groups other than the procerus and corrugator in glabellar wrinkle formation, and 17 (24.6%) presented asymmetrical contraction. Patients from the 5-point group with glabellar asymmetry and those who utilized the frontalis and orbicularis presented inferior performance ( < 0.05), reinforcing the importance of an individualized assessment and treatment plan.
CONCLUSION
The One21 technique yielded better results than the standard 5-point treatment in reducing glabellar dynamic lines with Incobotulinumtoxin-A, especially for asymmetric lines of the glabella or the involvement of muscle groups other than the procerus and corrugator.
PubMed: 33564254
DOI: 10.2147/CCID.S281901 -
Singapore Medical Journal Oct 2017This study describes the physician experience relating to the effectiveness of incobotulinumtoxinA and patient satisfaction with its use for the treatment of glabellar... (Observational Study)
Observational Study
INTRODUCTION
This study describes the physician experience relating to the effectiveness of incobotulinumtoxinA and patient satisfaction with its use for the treatment of glabellar frown lines (GFLs).
METHODS
A total of 17 patients from six dermatological clinics, aged > 18 years and with mild to very severe GFLs at maximum frown, were included. Patients were excluded if they had treatment with resorbable fillers and botulinum toxins in the preceding six months, or non-resorbable fillers or surgery in the treatment area. Injection sites (range 3-5) were chosen depending on their severity (dose range 12-20 U), covering corrugators and procerus muscles. Physicians assessed improvements to GFLs using the Merz scale on Days 4 and 14 after treatment. Patients completed a self-reported questionnaire on their facial wrinkles on Days 2 and 4 after treatment.
RESULTS
Most (76.5%) patients were women. The mean age of the patients was 46.9 ± 10.0 years. Mean severities (on the Merz scale) for at-rest and dynamic (with expression) GFLs at baseline were 1.3 ± 1.10 and 3.4 ± 0.38, respectively, and decreased on Day 14 (p < 0.05). Treatment response rates (> 1-point improvement) for at-rest and dynamic (with expression) GFLs on Day 4 were 40% and 100%, respectively. All patients reported being satisfied or very satisfied, and 64.3%-71.4% indicated that their facial wrinkles had improved on Day 2.
CONCLUSION
IncobotulinumtoxinA was fast acting with visible improvements by Day 4 and all patients expressed satisfaction with their treatment after two days. GFLs saw the most improvement among the facial characteristics measured.
Topics: Adult; Botulinum Toxins, Type A; Dermatology; Facial Expression; Female; Forehead; Humans; Male; Middle Aged; Neurotoxins; Patient Satisfaction; Prospective Studies; Severity of Illness Index; Skin Aging; Surveys and Questionnaires; Time Factors; Treatment Outcome
PubMed: 27357317
DOI: 10.11622/smedj.2016112 -
Folia Parasitologica 1997Intense infections of a variant of Myxobolus procerus (Kudo, 1934) are described from trout-perch (Percopsis omiscomaycus (Walbaum)) collected in Duluth Harbor, Lake...
Intense infections of a variant of Myxobolus procerus (Kudo, 1934) are described from trout-perch (Percopsis omiscomaycus (Walbaum)) collected in Duluth Harbor, Lake Superior, USA. This particular population of parasites has spores that are identical in shape (narrow pyriform) to those described for M. procerus except that they are significantly smaller (13-14.5 microm long versus 15-17 microm long). In contrast to what was originally described for M. procerus, the plasmodia develop primarily within red and white striated muscle fibres and only rarely among the subdermal connective tissue. Most plasmodia were at or near the same stage of development. Typical development involves growth within the fibre. The parasite eventually replaces the entire content of the host cell and appears to halt development before rupturing the outer cell membrane. The only obvious host response was an occasional cyst being invaded by a localized cellular infiltrate. Infected fish appeared of normal health and no grossly evident myoliquefaction was seen. The infections involved several hundred plasmodia per fish and the question of why such unusually high levels of infection would develop in hosts inhabiting a polluted habitat is raised. It is suggested that proliferation of a pollution tolerant oligochaete (the suspected alternate host) in the harbour and/or a compromised host immune system may have increased the probability of successful transmission and development in trout-perch living in the harbour.
Topics: Animals; Disease Outbreaks; Eukaryota; Fish Diseases; Fishes; Fresh Water; Genetic Variation; Minnesota; Muscles; Protozoan Infections, Animal
PubMed: 9229571
DOI: No ID Found -
Arquivos de Neuro-psiquiatria Aug 2012
Topics: Blepharospasm; Diagnosis, Differential; Dystonic Disorders; Facial Muscles; Humans; Male; Middle Aged; Tic Disorders
PubMed: 22899039
DOI: 10.1590/s0004-282x2012000800016 -
The British Journal of Ophthalmology May 1998Patients with thyroid eye disease with upper eyelid retraction often develop overaction of the accessory muscles of eyelid closure, the glabellar muscles corrugator... (Clinical Trial)
Clinical Trial
BACKGROUND/AIM
Patients with thyroid eye disease with upper eyelid retraction often develop overaction of the accessory muscles of eyelid closure, the glabellar muscles corrugator supercilii and procerus. The resultant glabellar furrowing (frown lines) contributes to the typical thyroid facies. The aim of this study was to evaluate the use of botulinum toxin A reversible chemodenervation of the glabellar muscles as adjunctive treatment in the rehabilitation of patients with thyroid eye disease.
METHODS
14 patients (13 females) ages 39-76 years (mean 52) with inactive thyroid eye disease and associated medial eyebrow ptosis and prominent glabellar frown lines were recruited. All patients had a history of upper eyelid retraction. Each patient was treated with a single botulinum toxin injection (Dysport 0.2 ml, 40 units) into each corrugator supercilii and sometimes procerus muscles as an outpatient procedure. The effectiveness and acceptability of the treatment was assessed clinically and from a patient questionnaire.
RESULTS
The injections were tolerated by 13/14 (93%) patients. There was resultant flattening of the glabellar region and improvement of medial eyebrow contour in all patients, with onset of paralysis within 1 week. All patients reported a subjective improvement in appearance. Side effects included one patient (7%) with reversible partial ptosis. The beneficial effect lasted 4-6 months, with a gradual return of function. Repeat treatment was indicated where there was persistent upper eyelid retraction and protractor overaction.
CONCLUSION
Botulinum toxin A chemodenervation of the glabellar muscles in these patients was effective and acceptable. Chemodenervation should be considered in the rehabilitation of patients with thyroid eye disease where there is upper eyelid retraction and overacting protractors resulting in a thyroid frown. Once the eyelid retraction has been successfully treated by surgery, the need for further glabella muscle chemodenervation is considerably reduced.
Topics: Adult; Aged; Botulinum Toxins, Type A; Esthetics; Eyebrows; Facies; Female; Graves Disease; Humans; Injections, Intralesional; Male; Middle Aged; Muscle Contraction; Muscle Denervation; Muscle, Skeletal; Rhytidoplasty
PubMed: 9713061
DOI: 10.1136/bjo.82.5.528