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Botulinum A Exotoxin for Hyperfunctional Facial Lines
Where Not to Inject
Arch Dermatol. 2002;138:1180-1185.
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THE TREATMENT of hyperfunctional facial lines with botulinum A exotoxin
injection is safe, usually effective, and without serious adverse effects.
Millions of individual clinical doses have been delivered without major complications.
The average lethal dose, at 40 U/kg (eg, 2800 U for a 70-kg person), is orders
of magnitude greater than the average dose delivered for glabellar frown lines
(15-50 U).1 Indeed, cosmetic use of botulinum
A exotoxin has become routine within dermatology. Initiated by pioneering
dermatologists, ophthalmologists, and otolaryngologists during the 1980s,
and honed by leaders in dermatologic surgery during the past decade,2-6
techniques for botulinum injection are now commonly taught in residency and
postgraduate education programs. Overall safety and efficacy, however, do
not imply that bothersome adverse effects seldom occur. There is understandable
reluctance to document these, which are usually mild and time limited.7-12
Yet adherence to a few simple guidelines can reduce the likelihood that the
patient . . . [Full Text of this Article]WHERE INJECTIONS ARE ALWAYS A PROBLEM
Too Close Above the Middle and Lateral Portions of the Eyebrow Under the Midbrow and Into the Medial Canthus Too Close to the Lateral Aspect of the Eyes On the Upper Cheek
WHERE INJECTIONS ARE OFTEN A PROBLEM
Everywhere at the Same Time
Only Into the Medial Aspect of the Forehead Directly Under the Lateral Aspect of the Eyebrows Directly Under the Eyes On the Upper Lip
WHERE INJECTIONS CAN CAUSE ADVERSE EFFECTS
Too Deep on the Hands for Palmar Hyperhidrosis
Too Deep on the Neck for Platysmal Bands Too Deep Elsewhere
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Arch Dermatol. 2002;138(9):1243-1244.
EXTRACT
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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Caveat Emptor (Buyer Beware)
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Arch Dermatol 2002;138:1243-1244.
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