Correction of facial wrinkles with botulinum toxin preparations has long been a part of the practice of cosmetologists. However, typical side effects after administration of a neurotoxin, such as ptosis of the upper eyelid or "eagle" eyebrows are still quite common.
Despite the fact that such phenomena do not threaten the health and life of the patient, they cause psychological discomfort that persists throughout the duration of the drug.
How to ensure maximum accuracy of botulinum toxin injection and impeccable correction results, estet-portal.com readers were told by Dr. Wolfgang Radish-Svoboda – plastic surgeon, Associate Professor of the Paracelsus Medical University in Salzburg, head of the anatomical course Expert Day Anatomy, member of the German Society of Surgeons, the Society of Mesotherapy, the European Academy of Aesthetic Surgery and the International Society of Aesthetic Medicine.
What is the role of knowledge in the field of anatomy when working with neurotoxins
When working with neurotoxins, knowledge of ordinary anatomy, i.e. the location of muscles or other anatomical structures are of secondary importance. To carry out correction with botulinum toxin, first of all, it is necessary to understand functional anatomy: to know how muscles work, in particular, facial ones, when it comes to working with the face.
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As you know, there are agonist and antagonist muscles, the nuances of which need to be known. The practitioner also needs to know which muscle to block and in which plane it is located – superficial or deep (on the bone).
To my great surprise, this problem is still relevant. We have been teaching anatomy to neurotoxin specialists for 5-6 years. But, despite this, patients with typical consequences of unsuccessful botulinum therapy, for example, "eagle" eyebrows are found everywhere. This happens because doctors neglect functional anatomy.
In order to perform a successful correction with botulinum toxin, it is first necessary to understand the functional anatomy.
Which danger points to be aware of when injecting botulinum toxin
To tell the truth, the only danger when working with neutrotoxins is the use of unregistered drugs (for example, manufactured in Asia). On the other hand, all side effects after the introduction of toxins are temporary and do not threaten the health or life of the patient. The problem of drooping of the upper eyelid or eyebrows is eliminated at the moment the action of the toxin ceases. Therefore, for me, correction with botulinum toxin is safer than correction with fillers.
Secrets of successful face correction with fillers from Dr. Wolfgang Radidka-Svoboda
Can chewing function be impaired after correction with botulinum toxin
As a general rule, the amount of toxin used to reduce masticatory muscle volume does not result in impaired masticatory function. Of course, in the case of the treatment of bruxism, it is necessary to first check the functionality of the muscles and the mobility of the mouth. Problems can arise in the presence of asymmetries. However, as part of the aesthetic correction with botulinum toxin, no impairment of masticatory or other functions should occur.
Tell me about correcting fine lines with a small amount of botulinum toxin
As you know, the location of the anatomical structures under the skin in the area around the eyes and cheeks is different. In the cheek area, this is the skin, subcutaneous fat and SMAS with muscles. In the perioral region, under the layer of skin is a fibrous tissue containing some fat, and under it are the muscles. Fibrous tissue consists of collagen and muscle fibers. And these muscle fibers lead to the appearance of purse-string wrinkles.
By injecting a weak solution of botulinum toxin through very small insertion points into the perioral region, these small muscle fibers that extend from the orbicularis ossicular muscle to the skin can be blocked and purse-string wrinkles can be smoothed out.
Technical aspects and perspectives of the lipofilling technique
The only problem is that it is very difficult to manually dose even a weak solution of botulinum toxin. And therefore, in my daily practice for the introduction of botulinum toxin preparations, I use Juvapen. This instrument provides exceptional accuracy of the procedure even when injecting standard doses of toxin.
Juvapen allows you to inject even the smallest amount of botulinum toxin with exceptional precision.
Therefore, if I need to treat three muscles at the same level, especially in the area between the eyebrows, while the mechanism is running, I have a second to inject the drug retrogradely. Thus, the introduction of neurotoxin at all levels is ensured.
It is practically impossible to do this manually, especially when it comes to small amounts of the drug. It is not difficult to inject 5, 6, 10 units of botulinum toxin, and the difference of 2 units with such a correction does not play a significant role. But if you need to inject a very small amount of botulinum toxin and do it with exceptional precision, Juvapen – just a fantastic tool.
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