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Clinical Procedures in Laser Skin Rejuvenation - part 9

Nó là rõ ràng, tuy nhiên, rằng, do ảnh hưởng phổ biến và an toàn tương đối của Botox, sự thay đổi tại các điểm tiêm và liều lượng đã giảm đáng kể tổng thể kết quả của sản phẩm đạt yêu cầu lâm sàng. Theo ý kiến của chúng tôi, liều lượng cần thiết cho một khu vực giải phẫu | 182 Clinical procedures in laser skin rejuvenation Fig. 16.1 The glabellar complex as demonstrated before and after injection of botulinum toxin. the need for a fundamental understanding of this muscular anatomy.7 It is clear however that due to diffusion effects and the relative safety of Botox the variability in points of injection and dosages has not significantly reduced the product s overall satisfactory clinical results. In our opinion required dosages for a given anatomical area can be reduced by precise localization and direct injection into the targeted muscle or muscle groups. It is imperative that one keep in mind not only the specific muscle locations when providing neuromodulator treatment but also the functional interrelationships of the muscle action. Many of these act as antagonistprotagonists in the position of the brow. The use of Botox in general has evolved with experienced and thoughtful injectors from a simple wrinkle treatment to a means of reshaping contouring and softening the facial features associated with aging and the stigmata of the frowning angry or worried facial form. Botox is frequently used to specifically target different muscular units. In the glabellar region targeting of the procerus and corrugator muscles is used to eliminate furrowing along the radix and medial eyebrow region. The lateral orbital region which is commonly referred to as the crow s feet is also a region in which Botox may be of use to target the orbicularis oculi muscle and reshape the upper face. The use of Botox in the forehead must be conservative in order to balance the risk of brow ptosis by targeting the only brow elevator the frontalis muscle. Perioral lip lines have also been treated with sparing amounts of Botox to suppress the pursing effect of the orbicularis oris muscle. One must be careful not to compromise oral competence as a result of this treatment. Botox injection into the depressor anguli oris muscle can target marionette lines and its use .