Objectives: To understand the mechanism of levator ptosis after toxin treatment of the glabella

Introduction: Levator ptosis is the most common complication after toxin treatment of the glabella. The orbicularis retaining ligament (ORL) provides a barrier between the forehead region contains the corrugated (and procures) muscles and the orbital cavity containing the levator palpebral muscle, so no toxin should be able to reach the levator. However, the terminal branches of the Ophthalmic artery make holes in the ORL through which toxin can travel into the orbital cavity. Bleeding and subsequent pressure application can push the toxin through the holes in the ORL towards the levator muscle.

Materials / method: We assessed 1291patients who underwent toxin injections in the glabella and measured arterial injury with Doppler.
We previously described a technology allowing to visualize the arterial anatomy in Augmented Reality (AR) and used this prior to toxin injections in the glabella in 350 patients

Results: Without AR visualization, 38% of patients had arterial injury after toxin injection is the glabella. The Supratrochlear Artery was most often injured (46%), followed by the Supraorbital Artery (37%) and the Dorsal Nasal Artery (17%).
With AR visualization, only 14% of patients had arterial injury.

Conclusion: Arterial injury and pressure application can explain the mechanism of levator ptosis after toxin injection. Arterial injury is very common after toxin injections is the glabella and can explain the relatively high incidence of levator ptosis.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
Yes
Please specify entities (individual, company, society): augmented anatomy

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: Describe in 7 min why I prefer peels than laser

Introduction: It’s an old story between laser and peels

Materials / method: Controversies
The bonus of peels
Handle
Cost
Danger
State or Art

Conclusion: For a such area , peels are always a goos alternative to laser

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
Yes
Please specify entities (individual, company, society): Speaker for Merz Aesthetics

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability