COSMETIC UPPER-FACIAL REJUVENATION WITH BOTULINUM

Objective: This study was conducted to evaluate the cosmetic use of bo tulinum toxin type A (Botox(TM)), which blocks the release of acetylch oline at the presynaptic neuromuscular junction leading to an irrevers ible, but temporary chemical denervation muscular paralysis and weakne ss. This produces a significant cosmetic improvement of wrinkling in t he upper face due to hyperfunctional animation. Method: A prospective clinical study representing our experience with this new technique is presented. Patient selection and evaluation, classification of animati on lines, techniques, results and complications are discussed. In a 15 -month period, 23 patients with seven anatomic sites were injected. Tw enty-three patients had the lateral aspect and the inferior aspect of their squint lines injected, and 26 patients had their glabellar frown lines injected. Results: Significant improvement occurred to the avera ge depth and length of the glabellar frownlines. The subjective improv ement by the patients was also significant. Regarding the crow's feet, the lateral canthal lines showed more improvement than the inferior l ateral canthal lines because the latter has a greater component of zyg omaticus major and minor muscle, which contributes to the inferior lat eral squint line. Conclusion: Botox is a safe, easy-to-use, effective modality for the temporary elimination of hyperfunctioning upper-facia l muscles.