Aesthetic Plastic Surgery

Botulinum toxin is a substance which reduces muscle contraction by acting at the neuromuscular junction (action myorelaxante).

Since 1975, doctors use botulinum toxin to correct strabismus in children, facial tics and uncontrollable blinking of the eye.

Botulinum toxin under the name BOTOX received in the United States, the authorization of the Food and Drug Administration (FDA) in 2002 for use in the treatment of wrinkles international eyebrow or wrinkles of the lion. ”

In February 2003, the French administrative authorities responsible for controlling drugs for the first time issued a license to market (AMM) in the interests aesthetic botulinum toxin under the name VISTABEL (laboratory ALLERGAN). This authorization for the use for cosmetic treatment of wrinkles of the glabella (wrinkles inter eyebrow or wrinkles of the lion “) under certain conditions competence of practitioners and terms of use.

In case of injections were performed in the field of aesthetic outside the sites, they would be made “off-label”.

In practice, the classic signs of botulinum toxin in the field of aesthetic concern wrinkles international eyebrow, forehead wrinkles and wrinkles on the feet.
Principles

The botulinum toxin is the use of muscle relaxation properties of this product.

The most often is to reduce the action of muscles located in the forehead and eyebrows to reduce wrinkles as well as horizontal vertical wrinkles caused by the contraction of the muscles.

This allows use to smooth the skin relief and get a rejuvenating effect upon release of muscle tension.

From a more global, we must realize that the position of the eyebrows is provided by a balance between two opposing forces, consisting of step-down muscle (located in the vicinity of the eyebrows), and an elevator muscle (the muscle front).

Horizontal wrinkles are caused by muscle contraction, which is front elevator. Wrinkles vertical inter-eyebrow are caused by muscle contraction step-down.
Objectives

The primary goal of treatment is to improve wrinkles and fine lines to rest and not to prevent muscle contraction: we therefore deem the result primarily on the appearance of wrinkles at rest.

As regards the balance between the muscles and step-down elevators, botulinum toxin by reducing the action of a group of muscles, reduces wrinkles caused by these muscles but frees the antagonistic action of muscles: the aim is to treat muscular balance and achieve a harmonization of the face.

Treatment with botulinum toxin should be designed and managed over time and should be treated gradually to avoid the possibility of “doing too much” during the first injections.

It is better to a first session moderately effective too efficient: it is not desirable to have a best result at the first injection.

In some cases it may be necessary to practice several sessions of injections prior to adapt the capabilities of the product for each patient (e).
Before injections

No preparation is necessary.

On the day of the injection, you do not need to be fasting. For women, there should be to come without makeup or to remove it before the injections.

It is very important to minimize the risk of bleeding treated areas to avoid taking aspirin during the 15 days preceding the injections and the 15 days that follow.

It is necessary to respect the against-the following:

* Neuromuscular diseases like myasthenia gravis.
* Pregnancy and breastfeeding: being pregnant, even a few days, necessitates postponing the date of injection after pregnancy and the cessation of breastfeeding possible. . It is therefore necessary in case of doubt to make the necessary examinations and to communicate the results to your doctor.
* Botulinum toxin is against-indicated in case of hypersensitivity to botulinum neurotoxin A or the serum albumin, and treatment with aminoglycosides (family of antibiotics which include including Amiklin and Gentalline).

It should also meet a number of precautions:

* If you are treated (e) otherwise by injections of botulinum toxin for pathological spasms, if you had an episode of paralysis of the muscles of the face, if you suffer from a neuro-muscular disease or disorder of the coagulation, you must participate in the practitioner who supports you for these injections of botulinum toxin. This judge then with your doctor about the advisability of injections on you and how to proceed as appropriate.
* If by injections, you are taking medicines like anti-coagulants or aspirin or antibiotics, or if you have any ill health (including infection, flu, abscessed tooth …) you must know your doctor before the injection.
* As a general rule, you should not hesitate to mention to your doctor, any health problems so that they appreciated the opportunity injection. In the same vein, you must provide him with all your questions and include all the treatments you may be or where you are still the object.

Type of anesthesia

No anesthesia is necessary.
Course of injections

The treatment will be done in the office of the practitioner or clinic according to the choices and habits of your physician.

This treatment is a series of injections in the face. The needle is fine, and injections are usually quite painful.

The duration of treatment is the order of minutes.
After the injections: suites

During the two hours after the injection, you are advised not to make sport intensive and not lie. It should also avoid handling facial or massage supported for 24 hours after the meeting.

It is very important to minimize the risk of bruising or bleeding treated areas during the two days before and two weeks after the injections (to reduce the risk of leakage of the product to the peripheral muscles which could lead unwanted effects).

Furthermore, during the three days following the injections, it is highly desirable to contract the muscles injected three times a day for about 5 seconds per muscle.

Usually the result of these injections are simple. Some brands remain somewhat inflated 20 to 30 minutes and then disappear. The patient (s) can resume their normal activities after the injections. Some rare side effects may occur. They are transient.

These may include:

* Redness: localized redness at injection sites has sometimes been reported and rarely persists beyond 3 to 6 days.
* Ecchymosis (blues): blueprints are rarely observed in areas of injection and can last several days.
* Edema: swelling, most often around the eyes, can gradually move into 4 to 5 days, then decrease in a few days to several weeks.
* Problems with sensitivity: a feeling of tension and fixity of the front of the mouth or neck, according to the injected areas, as well as changes in sensitivity often associated with a feeling of cardboard can persist for several days
* Pain or fleeting facial eye: such pain have been described in the areas injected in very exceptional.

Anyway, in the aftermath of these injections, do not hesitate to recall your doctor if you have any concerns.
The result

The result is a reduction of wrinkles with the conservation of small movements, it is obtained three to fifteen days after the injections.

Effects: The results are visible after a few days but for about 15 days, the effects on the face can be variable (see asymmetric at times) before eventually stabilize.

The result after the first session lasts an average of 3 to 6 months after which, the injection may be renewed.

Frequency of injections: injections must be performed several times with intervals of 3 to 6 months to get some stability with the result. Starting from the second injection, the results can be more sustainable (6 to 8 months). It should then repeat injections every 3 to 6 months.

It is recommended not to bring within 3 months of injections sessions to avoid creating resistance to produce a vaccine effect. ” The aspect of the result can be stabilized beyond 3 injections but in some cases, should be made to at least 8 to 10 injections to get some stabilization of the result.

In contrast, it should be noted that if you stop the injections, the muscle with its treaty before the injections.
The result of imperfections
LOCALIZED IMPERFECTIONS:

In some cases, localized defects (persistence of small wrinkles) can be observed only without real complications. They depend on the surface appearance of the skin that may, even before the injections, a “break” indelible due to length of the ride.

There may also insufficient results and even asymmetric: they are due to the fact that we have the muscles more or less powerful, and especially often asymmetrical.

These shortcomings are generally treated by a complementary injection of botulinum toxin, one month after the injection.

It should be noted that if an additional local injection may be advisable after an injection to make the result, it need not be conducted before the 15th day since the muscular balance (balance between muscle groups) take about 15 days to settle.
ASYMMETRY RESIDUAL:

A mismatch on both sides of the face and wrinkles more pronounced on one side than the other, exist in most cases before the injection.

Finally, the muscle responsible for the ride may be more powerful on one side than the other. This is usually analyzed before the injection. In such a case, injections will be using a technique slightly different from one side over another. Despite this precaution, a residual asymmetry may persist and may be eligible for a supplementary injection.

The acts referred to aesthetic aim to make it more happy and satisfy you in realistic proportions. Sometimes, however, and expected the effect is not achieved and that such acts contrary to the increase of psychological pre-existing. The experienced post-injection can be extremely different from one patient to another, even with a similar aesthetic result.

In the case of toxin Bolutique, rejuvenation is obtained in return for a reduction or even disappearance of some facial expressions. This aspect has been reviewed with you to avoid the risk of setbacks, especially if you are an actor, presenter, etc. …
The possible complications

Complications are rare.

The possible complications to date are:
LOCO-REGIONAL COMPLICATIONS:

* Headaches: they may be present in the setting of the first injection and disappear after a few hours to several days.
* Ptosis eyebrows: the injection of the front may cause a slight lowering of the eyebrows. This descent is usually due to the fact that the eyebrows were already low position before the injection. This slight lowering of the eyebrows usually regresses within a few weeks.
* Eyelid Ptosis: injection lion rides can cause a partial collapse of the upper eyelid, which can last 4 to 8 weeks. It is rare (less than 1% of cases), and always disappears beyond a few weeks.
* Discomfort or smile and swallowing: injection in the lips can cause discomfort to smile or small abnormal movements. The injection in the neck can lead to difficulty in swallowing.
* Dry eye: by decreasing lacrimal secretion may cause keratitis, particularly among patients with contact lenses (it should, in this case, be sure to moisten the cornea).
* Paradoxical contraction of a muscle disorder and mimicry: in the days following the injection, the treated muscles may have some paradoxical movements (spontaneous contractions) without gravity.

GENERAL COMPLICATIONS

They are quite exceptional:

* Allergic reaction: skin rash, hives, general allergic reaction.
* Nausea, dizziness
* Fatigue, fever, flu syndrome
* Dry skin or mouth.
These risks must be added the unpredictability of life and aspects, and finally, hazardous, or even unknown risks inherent in any medical procedure.

In total, we should not overstate the risks, but just be aware that any injection in the face still a small share of hazards.

The use of a qualified practitioner can assure you that it has the training and expertise to minimize these complications know where best to manage if necessary.

These are the elements of information that we wanted to bring you in addition to the consultation. We advise you to keep this document to read it again after the consultation and reflection “at their leisure.” This reflection can be lead to new questions for which you wait for additional information. We’re here to talk at a future consultation by phone or even the same day injections where we meet again, anyway, before they are made.

Filed under: Aesthetic Surgery

Tags: botolinium toxin, botox