Neurotoxins

2019 ◽  
Vol 35 (03) ◽  
pp. 230-238
Author(s):  
Adrian A. Ong ◽  
David A. Sherris

AbstractBotulinum toxin is integral to the practice of facial plastic surgery. Since it was approved by the U.S. Food and Drug Administration for the temporary improvement of glabellar rhytids in 2002, botulinum toxin has achieved a growing number of off-label clinical applications. These include the management of facial rhytids, brow ptosis, excessive gingival display, masseteric hypertrophy, platysmal banding, facial nerve paralysis, hypertrophic scars, and keloids. Many forms of botulinum toxin have been developed, and their safety and efficacy have been thoroughly established. This article will review the aesthetic and functional uses of botulinum toxin as it relates to the field of facial plastic and reconstructive surgery. In addition, the authors will discuss the suggested quantity of units per injection site based on onabotulinumtoxinA.

PM&R ◽  
2014 ◽  
Vol 6 (8) ◽  
pp. S114
Author(s):  
Agustin Gutierrez Ruiz ◽  
Leire Ortiz Fernandez ◽  
M. Paz ◽  
Abaitua Ezquerra ◽  
Maite Pacheco Boiso

2020 ◽  
Vol 53 (02) ◽  
pp. 219-229
Author(s):  
Izolda Heydenrych

AbstractThis article will describe facial asymmetry secondary to facial nerve paralysis (FNP), and review current concepts, guidelines, and future trends. Despite the increasing use of botulinum toxin (BoNTA) in treating FNP, ideal dosage, timing, and additional therapies are not unequivocally established. Facial asymmetry significantly impacts quality of life (QOL) by strongly affecting self-perception and social interactions; injectables may mediate great clinical improvement. This article provides practical guidelines for the use of BoNTA and provides schemes for accurate assessment and documentation. A systematic, stepwise approach is recommended with methodical assessment, meticulous placement, conservative dosage, and careful follow-up. Future trends include the potential use of newly developed toxins, muscle modification with fillers, improved imaging techniques, and targeted QOL studies. Hopefully, a growing number of aesthetic injectors may become technically proficient and join multidisciplinary teams for managing FNP.


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