By Goldman M.P., Sadick N.S., Weiss R.A.
Compiled through professional specialists within the box, this reference presents transparent counsel at the easy ideas, techniques, and problems thinking about complex dermatologic surgery-offering distinct insurance of filling elements, fats move concepts, and the most recent laser applied sciences.
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Additional resources for Advanced Techniques in Dermatologic Surgery
BTX-A is not injected at or under the mid-brow (38). Eyelid ptosis can be treated by using apraclonidine, which elevates the lid by 1 to 2 mm and compensates the loss of levator palpebrae superioris (Fig. 4). One or two drops three times a day can be continued until the ptosis resolves. However, it is important to note that allergic contact dermatitis can occur with the use of apraclonidine. Periorbital Complications Bruising, diplopia, ectropion, or a drooping lateral lower eyelid and an asymmetrical smile (caused by the spread of toxin to the zygomaticus major) are all reported complications of BTX-A in the periorbital area.
Now, a combination of soft-tissue augmentation and BTX-A injection of the mentalis, or BTX-A injections alone (in those who do not require augmentation) will soften this appearance of the chin. ‘‘Mouth Frown’’ Mouth frown—created by permanent downward angulation of the lateral corners of the mouth—is caused by the action of the DAO and the upward motion of the mentalis. We have discussed the injection of the DAO and mentalis separately above, because we initially approached those muscles as separate and distinct areas.
Starting with low doses and injecting more superﬁcially rather than deeply, limits the potential for complications (such as drooling and asymmetry), and injections should be symmetrical to ensure uniform postinjection movement. Injections are avoided in singers, musicians, or other patients who use their perioral muscles with intensity. When injecting the DAO, areas too close to the mouth, injection into the mental fold, and interaction with the orbicularis oris are avoided, as these all of which can result in a ﬂaccid cheek, incompetent mouth, or asymmetric smile.
Advanced Techniques in Dermatologic Surgery by Goldman M.P., Sadick N.S., Weiss R.A.