Injectable Success: From Fillers to Botox^®

ABSTRACT

The educated consumer seeks minimal downtime options to address the early signs of aging. These signs include a deepening of facial folds, an increase in muscle-induced wrinkling, and even a loss of facial volume. The use of fillers both dermal and subdermal and the use of the neurotoxin Botox^® have grown tremendously. The increase demand for these nonsurgical options for facial rejuvenation has created an added responsibility for physicians to remain current in injection technique and product safety. My technique has evolved, along with the predictability of the current fillers and our understanding of the actions of these products, from a safe and conservative fellowship base. A successful injector is one who understands the limitations and possibilities of the available fillers as well as the neurotoxin Botox^®. The happy patient is one who finds that doctor.

KEYWORDS

Injectables - fillers - Botox^® - technique - education

REFERENCES

• 1 Carruthers J, Fagien S, Malonasse S L et al.. Introduction to the census recommendations.  Plast Reconstr Surg. 2004;  114(6 suppl) i-iii
• 2 Turk J B, Parhiscar A. Bone source for craniomaxillofacial reconstruction.  Facial Plast Surg. 2000;  16 7-14
• 3 Heermann J. Unilateral patulous Eustachian tube with tinnitus, inner ear damage, vertigo and sudden deafness-collagen injection.  HNO. 1988;  36 13-15
• 4 Keefe J, Wauk L, Chu S. Clinical use of injectable bovine collagen: a decade of experience.  Clin Mater. 1992;  9 155-162
• 5 Duranti F, Salti G, Bovani B, Calendra M, Rosat M L. Injectable hyaluronic acid gel for soft tissue augmentation. A clinical and histological study.  Dermatol Surg. 1998;  24 1317-1325
• 6 Werschler W P. Overview of fillers.  Cosmetic Dermatol. 2006;  19 S4-S6
• 7 Fulchiero Jr G J, Parham Vetter P C, Obagi S. Subcision and 1320Nd:YAG nonablative laser resurfacing for the treatment of acne scars: a simultaneous split face single patient trial.  Dermatol Surg. 2004;  30 1356-1359 discussion 1360
• 8 Alam M, Omune N, Kaminer M S. Subcision for acne scarring technique and outcomes in 40 patients.  Dermatol Surg. 2005;  31 310-317 discussion 317
• 9 Vleggaar D. Facial volumentric correction with injectable poly L-lactic acid.  Dermatol Surg. 2005;  31(11 pt 2) 1511-1517 discussion 1517-8
• 10 Flaharty P. Radiance.  Facial Plast Surg. 2004;  20 165-169
• 11 Tzikas T L. Evaluation of the Radiance FN soft tissue filler for facial soft tissue augmentation.  Arch Facial Plast Surg. 2004;  6 234-239
• 12 Fitzgerald R. Utilization of treatment options for facial lipoatrophy.  Cosmet Dermatol. 2006;  19 S12-S19
• 13 Scott A B. Development of botulinum toxin therapy.  Dermatol Clin. 2004;  22 131-133
• 14 BOTOX Cosmetic Package insert, Allergan Corporation .Jan 2005
• 15 Contet-Audonneau J L, Jeanmaire C, Pauly G A. Histological study of human wrinkle structures: comparison between sun-exposed areas of the face, with or without wrinkles, and sun-protected areas.  Br J Dermatol. 1999;  140 1038-1047
• 16 Klein A W, Mantell A. Electromyographic guidance in injecting botulinum toxin.  Dermatol Surg. 1998;  24 1184-1186
• 17 Adamson P. The Aging Forehead. In: Bailey BJ Head and Neck Surgery Otolaryngology. Philadelphia; J. B. Lippincott Co. 1993
• 18 Hollinshead W H. Anatomy for Surgeons of the Head and Neck. 3rd ed. Philadelphia, PA; Harper & Row 1982: 291-323
• 19 Frankel A S, Kamer F M. Chemical browlift.  Arch Otolaryngol Head Neck Surg. 1998;  124 321-323
• 20 Kane M A. Nonsurgical treatment of platysmal bands with injection of botulinum toxin A.  Plast Reconstr Surg. 1999;  103 656-663 discussion 664-5