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

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: This presentation shows how the toxin can be used to eradicate skin lines on the upper face.

Introduction: Botulinum toxins act by inhibiting the release of acetylcholine from presynaptic nerve endings, causing chemical denervation and resultant muscle paresis. It is effectively useful in controlling dynamic wrinkle lines on upper face. Studies showed that patients are usually satisfied with the treatment outcome when treatment is applied on the upper face.

Materials / method: Glabellar rhytides can be effectively treated with Botulinum toxin(BoNTA) injection. Other dynamic upper facial line that are effectively treated with the toxin include horizontal forehead lines and lateral canthal lines (crow’s feet). A minor brow lifts and elevation of upper eyelids are noticed when the glabella lines are treated. Excellent result is also attained for nasal scrunch (bunny lines) which tends to appear as a compensatory reaction when the glabella muscles are paralysed to remove glabella rhytides. Fairly good results can be obtained with infraorbital crow’s feet and hypertro

Results: The technique of BoNTA injection is important to obtain optimal results and minimize side effects. This is especially important when small muscle bundles are targeted e.g. corrugator muscles and procerus muscles and the superior portion of the orbicularis oculi muscles. Understanding the anatomy and evaluating each patient under dynamic and resting conditions can help avoid complications. It is useful to take good "before" and “after” photos and have the patient carefully show you their expectations.

Conclusion: Complications may occur hours to weeks after the injection. The commonest complication is eyelid ptosis when injected toxin diffuse from the corrugator muscle compartment through the orbital septum paralyzing the levator palpebrae superioris muscle. Temporary correction of ptosis can be achieved with alpha adrenergic agonist eye drop e.g. brimonidine 0.15% TDS. The other complications include brow ptosis, bruising, facial asymmetry, lateral eyebrow elevation(quizzical brows) and lack of facial expression (wooden look).

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