The series will put these cosmetic treatments into the hands of the physician the patient knows and trusts the most, and will bring primary care practitioners increased autonomy, improved patient satisfaction, and added reimbursement. This book provides thoroughly illustrated step-by-step instructions on botulinum toxin injection procedures and advice on managing common issues seen in follow-up visits.
Each chapter focuses on a single procedure and reviews all relevant anatomy, including target muscles and their functions and muscles to be avoided. Injection points and the injection Safety Zones are highlighted to help practitioners perform the procedures more effectively and minimize complication risks. Initial chapters cover treatment in the upper third of the face for frown lines, horizontal forehead lines, and crow's feet—procedures suited for practitioners who are getting started with cosmetic botulinum toxin treatments.
Subsequent chapters cover more advanced face and neck procedures and treatment of axillary hyperhidrosis. Features Include: Full-color design Includes numerous full-color photos Includes companion website with videos of every procedure Offers step-by-step instructions for each procedure. Help Centre. My Wishlist Sign In Join. Be the first to write a review. Add to Wishlist. Ships in 15 business days.
Using Botulinum Toxins Cosmetically: A Practical Guide
Link Either by signing into your account or linking your membership details before your order is placed. Description Table of Contents Product Details Click on the cover image above to read some pages of this book! All Rights Reserved. In Stock. John Murtagh's Companion Handbook 6th Edition. Identifying the specific muscles involved in cervical dystonia prior to the injection is important. Those most commonly injected are the sternocleidomastoid, trapezius, splenius capitis, and levator scapulae muscles. An EMG study of patients found that 2 or 3 muscles commonly are abnormal.
Eighty-nine percent of patients with rotating torticollis had involvement of the ipsilateral splenius capitis and contralateral sternocleidomastoid with or without the additional involvement of the contralateral splenius capitis. Patients with laterocollis had ipsilateral sternocleidomastoid, splenius capitis, and trapezius involvement, while retrocollis was produced by bilateral splenius capitis activity.
Beneficial effect from toxin injection usually is apparent in days.
Maximum response from the toxin is reached in approximately weeks and lasts for an average of 12 weeks. Injections usually are repeated every months. Neck weakness, dysphagia, and local pain at the injection site are the most commonly reported side effects. Other adverse effects eg, local hematoma, generalized fatigue, lethargy, dizziness, dry mouth, dysphonia, flulike syndrome, pain in neighboring muscles also have been reported. The incidence of adverse effects varies based on the dosage used ie, the higher the dose, the more frequent the adverse effects ; however, Jankovic and Schwartz reported that incidence of complications was not related to the total dose of BoNT used.
Dysphagia has been the most prevalent significant complication and most probably is related to diffusion of the toxin into nearby pharyngeal muscles. Spasticity is defined as a velocity-dependent increase in muscle tone. Different studies have shown the effectiveness of BoNT-A injection in the management of spasticity. Table 2. Borg-Stein et al [ 97 ].
A Practical Guide to Botulinum Toxin Procedures
Snow et al [ 98 ]. Hyman et al [ 99 ]. Koman et al [ ] Koman et al [ ]. Cosgrove et al [ ]. Corry et al [ ]. Fehlings et al [ ]. Wissel et al [ ]. Baker et al [ ].
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Edwards et al [ ]. Bhaktha et al [ ]. Smith et al [ ]. Childers et al [ ]. Pittock et al [ ]. Brashear et al [ ]. Bakheit et al [ ]. Yablon et al [ ]. Pavesi et al [ ]. Use of BoNT-A in the management of different pain disorders is being studied. The exact mechanism of action behind BoNT's analgesic effect is not known; however, a study by Purkiss and colleagues showed that BoNT inhibits calcium-dependent release of substance P in embryonic dorsal root ganglia. Based on the research with animal models, BoNT-A in peripheral nociceptive neurons plays a direct role in its peripheral analgesic effect and an indirect role in its central analgesic effect because of retrograde transport.
In a double-blind, randomized, placebo-controlled study, Foster and colleagues showed the efficacy of U of BoNT-A injection, using 40 U per site at 5 lumbar paravertebral levels on the side of maximum discomfort, in chronic low back pain patients.
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A Cochrane review regarding the use of BoNT-A injection for chronic low back pain has concluded evidence that BoNT injections improved pain, function, or both better than saline injections was limited, as was evidence this was better than acupuncture or steroid injections. BoNT-A injection has also been studied for chronic neck pain, cervicogenic headache, and whiplash-associated neck pain; however, a Cochrane review and systematic review and meta-analysis by Langevin et al concluded that current evidence fails to confirm either a clinically important or a statistically significant benefit of BoNT-A injection for whiplash-associated neck pain and chronic neck pain associated with or without cervicogenic headache.
BoNT-A has been studied to treat different neuropathic pain disorders such as postherpetic neuralgia, [ ] trigeminal neuralgia, [ , ] and diabetic peripheral neuropathic pain, [ ] and has shown to be effective in managing pain in these conditions. Different studies on the use of BoNT in the management of different pain disorders are listed in Table 3. Table 3. Zwart et al [ ]. Sherman et al [ ].
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Paulson et al [ ]. Wheeler et al [ ]. Myofascial pain [ ]. Wheeler [ ]. Schulte-Mattler et al [ ].
Freund et al [ ]. Silberstein et al [ ]. Rollnik et al [ ]. Barwood et al [ ]. Porta [ ]. Adverse events due to therapeutic and cosmetic injection of BoNT reported to the FDA include respiratory problems, dysphagia, seizure, flulike syndrome, facial and other muscle weakness, ptosis, and skin and injection site reactions. Clinical characteristics submitted to the FDA for therapeutic cases differed from those of cosmetic BoNT cases, which were usually less serious. Most of the adverse effects linked to local tissue diffusion of BoNT. Careful attention to drug dose, dilution, handling, storage, and site of injection are required for optimal treatment outcome and to minimize adverse effects.
What is botulinum toxin BoNT? What is the molecular structure and proteolytic activity of botulinum toxin BoNT? What was the evolution of therapeutic botulinum toxin BoNT? What is the mechanism of action in botulinum toxin BoNT? How does the potency vary among different commercial preparations of botulinum toxin BoNT? Which focal dystonias are treated with botulinum toxin injection? In which conditions is spasticity treated with botulinum toxin BoNT injection? Which nondystonic disorders of involuntary muscle activity are treated with botulinum toxin BoNT injections? In which conditions are chronic pain and localized muscle spasms treated with botulinum toxin BoNT injections?
Bruxism: a practical guide to treatment with botulinum toxin type A | Journal of Aesthetic Nursing
Which smooth muscle hyperactive disorders are treated with botulinum toxin BoNT injections? Which cosmetic procedures use botulinum toxin BoNT injections? Which sweating, salivary, and allergy disorders are treated with botulinum toxin BoNT injections? What is the efficacy of botulinum toxin BoNT in the treatment of focal dystonias? How is botulinum toxin BoNT administered in the treatment of focal dystonias? What are the possible complications of botulinum toxin BoNT in the treatment of focal dystonias?
What is the efficacy of botulinum toxin BoNT injections for the treatment of spasticity? What is the role of botulinum toxin BoNT in pain management?
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