Objectives: A “Domino effect” while botulinum therapy can appear when we don’t consider a synergy and antagonism of of target and intact facial muscles. It is not always a desirable aesthetic result, which looks like the domino effect, when one of the zones correction leads to an activation of other muscles with an undesirable aesthetic result. This effect can be prevented and treated.

Introduction: Toxin therapy shouldn’t be directed to separate muscles. It should be aimed at the features of the interaction of facial muscles. Unfortunately, interactions between them is not always under control of direct synergy and antagonism. These interactions are more complicated than it is usually considered.

Materials / method: A review and analysis of many own clinical cases have been conducted during a long practice. Groups muscles analysis was conducted while certain mimic tests. Kinematic chains were discovered for every individual patient’s mimic patterns, in which target and additional muscles were defined. Doses were divided among muscles depending on their activity and contribution into mimic pattern realization.

Results: We got a satisfactory aesthetic correction in all cases while individual choice of botulinum toxin doses and the target injection points. Despite the fact that this strategy differed from the standard injection points and doses, this approach is justified and allows to prevent the “Domino effect” from muscles unaccounted for the correction, which are included into the certain kinematic chain and can be activated.

Conclusion: The prevention of the “Domino effect” is more preferable than the treatment following. A construction of the whole kinematic chains is very useful in prognosis of botulinum toxin therapy results. Understanding of development of a new muscular relations let us prevent undesirable aesthetic results in the way of working with the whole kinematic chains.

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: How to evaluate and predict Bont-A effects at the moment of treatment

Introduction: During the last two decades the view of injectable treatments have changed both for doctors and patients. Rather then focusing on one treatment area we create treatment programs to achieve balance and harmony for our patients.
Today we understand the origin of dermal aging, creation of lines and morphological changes of the face with age. This understanding has led to that treatments now regularly combines BoNT-A neuromodulators.

Materials / method: We see the effect of Neuromodulators after our patients have left our offices, which makes the treatment challanging. Doing the perfect treatment is of course getting to know each individual patients. But results can be predicted and a better result can be achieved without the need for touchups.
Here practical tips on how to asses and evaluate your patients will be presented.

Results: Using this way of evaluating patients we can predict brow ptosis, mefisto effect and other not wanted results.

Conclusion: Neuromodulators are the number one treatment in cosmetic injectables, creating high satisfaction with low amount of adverse events is mandatory to create a trustfull relationship and high retention rate with our patients.

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