BOOK
Botulinum Toxin E-Book
Alastair Carruthers | Jean Carruthers | Murad Alam | Jeffrey S. Dover
(2012)
Additional Information
Book Details
Abstract
This title in the PROCEDURES IN COSMETIC DERMATOLOGY SERIES presents up-to-the-minute, practical guidance on botulinum toxin injection techniques shaping today's practice. Succinctly written and lavishly illustrated, it focuses on procedural how-to's and offers step-by-step advice on proper techniques, pitfalls, and tricks of the trade—so you can refine and hone your skills...and expand your surgical repertoire. You'll find current, to-the-point guidance on the cosmetic use of the toxin — edited by pioneers in the field, Drs. Jean and Alastair Carruthers. Implement the newest procedures into your practice immediately and confidently—with the outstanding guidance you'll find in this volume of the PROCEDURES IN COSMETIC DERMATOLOGY SERIES.
- Covers the hottest topics—including botox aesthetics, facial treatments, neck treatment, adjunctive treatment, pain relief, and facial asymmetry—all in one concise, accessible volume.
- Features a wealth of color illustrations and photographs that depict cases as they present in practice.
- Discusses common pitfalls and emphasizes how to optimize outcomes, enabling readers to improve their technique.
- Highlights emerging topics in the field, with guidance on the newest developments in cosmetic surgery.
- Includes a comprehensive, instructional DVD containing video clips of techniques and procedures as well as the experts' hints and tips.
- Use of fillers in combination with Botox to better sculpt the lower face
- Coverage of new fillers like Juvederm, Evolence, Radiesse and Perlane to keep you on the cutting edge
- New and expanded coverage of periocular treatment
- Highest quality video footage of procedures on the bonus DVD
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Half title page | i | ||
| Series page | ii | ||
| Botulinum Toxin | iii | ||
| Copyright page | iv | ||
| Table of Contents | v | ||
| Series Preface to the Third edition | vii | ||
| Series Preface | ix | ||
| Preface | xi | ||
| contributors | xiii | ||
| Acknowledgments | xv | ||
| Dedication | xvii | ||
| 1 Therapeutic uses of the botulinum toxins | 1 | ||
| Introduction | 1 | ||
| Hyperfunctional muscular uses | 2 | ||
| Cervical dystonia (spasmodic torticollis) | 2 | ||
| Autonomic nervous system use | 3 | ||
| Afferent nervous system / pain syndromes / anti-inflammatory | 4 | ||
| Glandular and secretory cell modulation | 4 | ||
| Further reading | 4 | ||
| 2 History of onabotulinumtoxinA therapeutic | 6 | ||
| Introduction | 6 | ||
| Identification, isolation, and characterization | 6 | ||
| Exploration of clinical potential | 7 | ||
| Nomenclature | 8 | ||
| Developed indications for onabotulinumtoxinA | 8 | ||
| Strabismus | 8 | ||
| Blepharospasm | 8 | ||
| Cervical dystonia | 10 | ||
| Glabellar lines | 10 | ||
| Primary focal hyperhidrosis | 10 | ||
| Adult post-stroke spasticity | 10 | ||
| Juvenile cerebral palsy | 10 | ||
| Chronic migraine | 10 | ||
| Neurogenic detrusor overactivity | 11 | ||
| Cell-based potency assay | 11 | ||
| Commentary | 11 | ||
| Acknowledgments | 11 | ||
| Further reading | 11 | ||
| 3 History of cosmetic botulinum toxin | 13 | ||
| Introduction | 13 | ||
| Serendipitous discovery | 13 | ||
| Patient zero and the first clinical trials | 14 | ||
| FDA approval | 16 | ||
| The face of BoNT | 17 | ||
| Further reading | 17 | ||
| 4 Basic science: BOTOX® Cosmetic | 18 | ||
| Introduction | 18 | ||
| Serotypes and structure | 18 | ||
| Role of NAPs | 19 | ||
| Manufacturing | 19 | ||
| Formulation | 19 | ||
| Mechanism of action | 20 | ||
| Dissociation of NAPs from the 150 kDa neurotoxin | 20 | ||
| Binding | 20 | ||
| Internalization and translocation | 20 | ||
| Cleavage | 20 | ||
| Recovery of neurotransmitter release | 21 | ||
| Potential actions on the sensory system | 21 | ||
| Immunogenicity | 21 | ||
| Clinical pharmacology of onabotulinumtoxinA in aesthetics | 22 | ||
| Approvals | 24 | ||
| Unique dosing of neuromodulators | 24 | ||
| Conclusion | 24 | ||
| Acknowledgments | 25 | ||
| Further reading | 25 | ||
| 5 Basic science: | 26 | ||
| Clinical studies performed for abobotulinumtoxinA | 28 | ||
| Treatment of the upper face | 30 | ||
| Glabellar lines | 30 | ||
| Forehead lines | 30 | ||
| Lateral eyebrow lift | 31 | ||
| Crow’s feet | 31 | ||
| Treatment of the lower face | 32 | ||
| Further reading | 33 | ||
| 6 Basic science: | 35 | ||
| Introduction | 35 | ||
| Properties of incobotulinumtoxinA | 35 | ||
| Purity | 35 | ||
| Stability | 36 | ||
| Diffusion | 36 | ||
| Immunogenicity | 37 | ||
| Clinical performance of incobotulinumtoxinA | 37 | ||
| Introduction | 37 | ||
| Neurological indications | 37 | ||
| Safety summary in neurological conditions | 38 | ||
| Aesthetic indications | 38 | ||
| Safety in aesthetics | 38 | ||
| Summary | 39 | ||
| Clinical experience with incobotulinumtoxinA | 39 | ||
| The total face approach with incobotulinumtoxinA | 39 | ||
| Conclusion | 41 | ||
| Further reading | 41 | ||
| 7 Basic science: | 43 | ||
| 3D basic science: Myobloc® | 43 | ||
| Pharmacology of botulinum toxin B | 43 | ||
| Immunogenicity | 44 | ||
| Myobloc® in the aesthetics practice | 44 | ||
| Efficacy in the treatment of hyperkinetic rhytides | 44 | ||
| Dose response | 47 | ||
| Onset and duration | 47 | ||
| Diffusion and spreading | 47 | ||
| Tolerability and safety | 47 | ||
| Myobloc® in the treatment of hyperhidrosis | 48 | ||
| Treatment considerations for Myobloc® | 48 | ||
| Summary | 48 | ||
| Conclusion | 48 | ||
| Further reading | 50 | ||
| 8 Medytoxin / Neuronox® | 52 | ||
| Introduction | 52 | ||
| Microbiological, physicochemical, and biochemical profiles | 52 | ||
| Clinical studies for Neuronox® | 52 | ||
| Reconstitution and handling | 53 | ||
| The use of Neuronox® in Asians | 53 | ||
| Further reading | 57 | ||
| 9 Comparison of botulinum toxins | 59 | ||
| Introduction | 59 | ||
| Types of botulinum toxin A | 59 | ||
| Mechanism of action | 61 | ||
| Compositional differences | 61 | ||
| Dosing | 62 | ||
| Efficacy | 63 | ||
| Duration of action | 63 | ||
| Diffusion / field of effect | 64 | ||
| Safety | 64 | ||
| Resistance | 64 | ||
| Storage | 65 | ||
| Conclusion | 65 | ||
| Further reading | 65 | ||
| 10 Topical neurotoxin | 67 | ||
| Background | 67 | ||
| Need for transcutaneous delivery systems | 67 | ||
| Potential approaches to transcutaneous delivery of BoNT-A | 68 | ||
| Potential applications of topical BoNT-A | 70 | ||
| Further reading | 70 | ||
| 11 Reconstitution / Dilution | 72 | ||
| Reported substances used in the reconstitution process | 72 | ||
| Unpreserved saline | 72 | ||
| Preserved saline | 72 | ||
| Hyaluronidase | 72 | ||
| Sterile water | 72 | ||
| Epinephrine and / or lidocaine | 72 | ||
| Bupivacaine | 73 | ||
| Albumin | 73 | ||
| Variations in the reconstitution process | 73 | ||
| Foam during reconstitution | 73 | ||
| Storage | 74 | ||
| Shelf life after reconstitution | 74 | ||
| Fresh or frozen | 74 | ||
| Sterility | 74 | ||
| Dilution issues | 74 | ||
| Facial muscles | 75 | ||
| Cosmetic indications | 75 | ||
| Blepharospasm | 75 | ||
| Non-facial muscles | 75 | ||
| Experimental studies | 75 | ||
| Limb muscle dystonias / spasticity | 75 | ||
| Hyperhidrosis | 75 | ||
| Further reading | 76 | ||
| 12 Glabella | 77 | ||
| Introduction | 77 | ||
| Anatomy | 77 | ||
| Injection technique (see Video ‘Botulinum Toxin Glabella’) | 77 | ||
| Dosing | 78 | ||
| Botox® (onabotulinumtoxinA) (Fig. 12.3) | 78 | ||
| Dysport® (abobotulinumtoxinA) (Figs 12.4 and 12.5) | 79 | ||
| Xeomin® (incobotulinumtoxinA) (Fig. 12.6) | 80 | ||
| Myobloc® (rimabotulinumtoxinB) | 82 | ||
| Special considerations | 82 | ||
| Men | 82 | ||
| Ethnic variation | 83 | ||
| Potential adverse events | 83 | ||
| Conclusion | 83 | ||
| Further reading | 83 | ||
| 13 Eyebrow height / shaping | 85 | ||
| Introduction | 85 | ||
| Eyebrows and attractiveness | 86 | ||
| Anatomy | 86 | ||
| Technique | 87 | ||
| Eyebrow asymmetry | 90 | ||
| Conclusion | 91 | ||
| Further reading | 92 | ||
| 14 Frontalis and HFL | 93 | ||
| Introduction | 93 | ||
| Side effects | 93 | ||
| Injection techniques | 94 | ||
| Treatment of scars | 96 | ||
| Conclusion | 98 | ||
| Further reading | 98 | ||
| 15 Treatment of crow’s feet | 100 | ||
| Introduction | 100 | ||
| Anatomy of ‘crow’s feet’ lateral orbital rhytides | 100 | ||
| The youthful eye | 101 | ||
| The aging eye | 102 | ||
| Preoperative assessment | 102 | ||
| Treatment | 103 | ||
| Adjunctive treatments | 106 | ||
| Complications | 107 | ||
| Conclusion | 109 | ||
| Further reading | 109 | ||
| 16 Infraorbital / upper and lower eyelids | 110 | ||
| Introduction | 110 | ||
| Anatomy of the eye | 110 | ||
| Periorbital aging | 111 | ||
| Patient assessment and selection | 111 | ||
| Indications and techniques | 112 | ||
| General considerations | 112 | ||
| Hypertrophic orbicularis, infraorbital rhytides, and widening of the eye | 112 | ||
| Lid ptosis, malposition, and asymmetry | 113 | ||
| Adjunctive treatments for the lid | 114 | ||
| Topical agents | 114 | ||
| Surgery | 114 | ||
| Lasers and light-based therapies | 114 | ||
| Soft tissue augmentation | 115 | ||
| Bimatoprost | 115 | ||
| Adverse events | 115 | ||
| Conclusion | 115 | ||
| Further reading | 115 | ||
| 17 Treatment of the mid-face with botulinum toxin | 117 | ||
| Introduction | 117 | ||
| ‘Bunny’ / nasal sidewall scrunch lines | 117 | ||
| Injection sites / dosage | 118 | ||
| Adverse effects | 119 | ||
| Levator labii superioris alequae nasii | 119 | ||
| Injection sites / dosage | 119 | ||
| Adverse effects | 120 | ||
| Zygomaticus complex | 120 | ||
| Injection sites / dosage | 120 | ||
| Risorius | 121 | ||
| Injection sites / dosage | 121 | ||
| Adverse effects | 121 | ||
| Conclusion | 121 | ||
| Further reading | 121 | ||
| 18 Orbicularis oris, mentalis, depressor anguli oris | 123 | ||
| Introduction | 123 | ||
| Anatomy | 123 | ||
| Perioral and chin aging | 124 | ||
| Differences in the use of BoNT for the upper and lower face | 125 | ||
| Rejuvenation | 125 | ||
| Patient selection for botulinum toxin perioral and chin rejuvenation | 125 | ||
| Target muscle | 126 | ||
| 19 Platysma and the Nefertiti Lift® | 129 | ||
| Introduction | 129 | ||
| The platysma: anatomy and dynamic aesthetic clinical implications | 129 | ||
| Injection techniques for the neck | 130 | ||
| Vertical bands | 130 | ||
| Horizontal folds | 130 | ||
| The Nefertiti Lift® | 130 | ||
| Potential complications of the Nefertiti Lift® | 132 | ||
| Conclusion | 132 | ||
| Further reading | 134 | ||
| 20 The masseters and their treatment with botulinum toxin | 135 | ||
| Introduction | 135 | ||
| History | 135 | ||
| Anatomy | 136 | ||
| The bony framework | 136 | ||
| Masseter muscle | 136 | ||
| Temporalis muscle | 137 | ||
| Surface anatomy of the masseter muscle | 137 | ||
| Raison d’être for botulinum injection of the masseters in the lower face | 137 | ||
| Bruxism | 137 | ||
| Treatment of the masseter muscle for shaping and beautification of the lower face | 137 | ||
| Treatment method | 139 | ||
| Injecting masseters | 139 | ||
| Complications | 140 | ||
| Conclusion | 140 | ||
| Further reading | 141 | ||
| 21 Darker skin types | 142 | ||
| Introduction | 142 | ||
| Racial / ethnic differences in photoaging | 142 | ||
| Safety and efficacy of botulinum toxins in darker skin types | 142 | ||
| African-Americans | 143 | ||
| Asians | 149 | ||
| Brazilians | 149 | ||
| Ethnic specific applications of botulinum toxin | 149 | ||
| Conclusion | 149 | ||
| Further reading | 150 | ||
| 22 Combination treatment | 151 | ||
| Introduction | 151 | ||
| Soft tissue augmentation | 151 | ||
| Lasers and light-based therapies | 153 | ||
| Ablative lasers | 153 | ||
| Non-ablative light sources | 155 | ||
| Aesthetic surgery | 156 | ||
| Endoscopic brow lift | 156 | ||
| Blepharoplasty | 157 | ||
| Facelift | 157 | ||
| Wound healing and scars | 157 | ||
| Conclusion | 158 | ||
| Further reading | 158 | ||
| 23 Focal axillary hyperhidrosis | 160 | ||
| Introduction | 160 | ||
| Sweating | 160 | ||
| Hyperhidrosis | 160 | ||
| Epidemiology | 161 | ||
| Quality of life | 161 | ||
| Clinical assessment of hyperhidrosis | 161 | ||
| Botulinum toxin therapy | 162 | ||
| Axillary hyperhidrosis | 164 | ||
| Use of botulinum toxin type B for hyperhldrosis | 165 | ||
| Techniques for non-axillary hyperhidrosis | 166 | ||
| Future directions | 167 | ||
| Further reading | 167 | ||
| 24 Palmo-plantar hyperhidrosis | 169 | ||
| Introduction | 169 | ||
| Patient evaluation | 169 | ||
| General considerations | 170 | ||
| Marking the treatment areas | 171 | ||
| Anesthesia | 171 | ||
| Dilution and injection | 172 | ||
| Injection technique | 172 | ||
| Results and follow-up | 173 | ||
| Complications | 173 | ||
| Conclusion | 173 | ||
| Further reading | 173 | ||
| 25 The future of botulinum toxin | 175 | ||
| Introduction | 175 | ||
| Newer indications | 175 | ||
| Topical versus injectable | 176 | ||
| Changes in the toxin molecule | 176 | ||
| Central effects of the neurotoxin | 177 | ||
| Depression | 177 | ||
| Conclusion | 177 | ||
| Further reading | 177 | ||
| Index | 179 | ||
| A | 179 | ||
| B | 179 | ||
| C | 179 | ||
| D | 180 | ||
| E | 180 | ||
| F | 181 | ||
| G | 181 | ||
| H | 181 | ||
| I | 181 | ||
| J | 181 | ||
| K | 181 | ||
| L | 181 | ||
| M | 182 | ||
| N | 182 | ||
| O | 182 | ||
| P | 182 | ||
| Q | 182 | ||
| R | 183 | ||
| S | 183 | ||
| T | 183 | ||
| U | 183 | ||
| V | 183 | ||
| W | 183 | ||
| X | 183 | ||
| Z | 183 |