[Botulinum toxin and wrinkles: few side effects and effective combining procedures with other treatments].
[Botulinum toxin and wrinkles: few side effects and effective combining procedures with other treatments].
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DOI：
10.1016/j.anplas.2004.09.002
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发表时间：
2004-10-01
期刊：
影响因子：
--
通讯作者：
Rossi, B
中科院分区：
文献类型：
--
作者：
Ascher, B;Rossi, B
化学去神经支配，通过肉毒杆菌毒素的生物作用，提供了一个非常有效的，低风险的，持久的治疗多动皱纹，主要是上脸。患有此类心律失常的患者在接受手术肌切开术或其他替代药物治疗时，风险更大，效果可能更不持久。肉毒杆菌毒素在过去的20年里被广泛应用于医学的许多领域。它已经在皮肤科和整形外科使用了13年，没有重要的并发症或后遗症。任何并发症似乎都是可逆的。在这两个专科，由于注射材料的数量（单位）和体积很小，并发症很少发生；其中一些现在已成为传闻。从美容角度来看，唯一的主要并发症是上睑下垂，这种情况越来越罕见。由于对受影响的肌肉有了更好的解剖学知识，以及我们改进的技术，风险大大降低了。在我们最近的两项关于眉间皱纹的多中心研究中，在2002年到2004年间，我们没有发现眼睑下垂。相反，如果与肌肉、脂肪和皮肤复发相关的动态皱纹和/或深沟，则只有外科手术和/或其他表面处理有效。肉毒杆菌毒素注射并不意味着取代上、中、下颌面部和颈部提升术；事实上，注射肉毒杆菌毒素可能会优化这些外科手术的结果。这些注射在产生持久效果的过程中起着重要作用。在整容手术中，当前和未来的发展是朝着完全实现，但集中，自然和微创的外科手术，结合有效和最小风险的技术，如肉毒杆菌毒素注射。为了达到最佳的治疗效果，应在手术前三周注射肉毒杆菌毒素。此外，注射肉毒杆菌毒素可以优化和延长表面手术的效果，如激光、去皮和填充。这种医外科结合是最好地描述2004年整形和美容手术发展的例子之一。
Chemical denervation, through the biologic effect of botulinum toxin, provides a very effective, low risk, lasting treatment for hyperkinetic wrinkles, mainly of the upper face. Patients with such rhytides, when treated with surgical myotomies or other alternative medical treatments, are at greater risk and with potentially less lasting results. Botulinum toxin has been widely used for the last 20 years in many areas of medicine. It has been used for 13 years in dermatology and plastic surgery, without important complications or sequellae. Any complications appear to be reversible. In these two specialties, with the minute quantities (units) and volume of material injected, complications are infrequent; some of them are now anecdotal. The only main complication from a cosmetic point of view is blepharoptosis, which is more and more rare. Because of a better anatomical knowledge of the affected muscles, and our improved technique, risks are greatly reduced. In our two latest multicenter studies on glabellar wrinkles, between 2002 and 2004, we saw no blepharoptosis. Conversely, in case of dynamic wrinkles associated with muscle, fat, and skin relapse, and/or deep furrows, only surgical procedures and/or other surface treatments are effective. Botulinum toxin injections are not meant to replace upper, mid, or mandibular face and neck lifts; indeed, botulinum toxin injections may optimize results from these surgical procedures. These injections play a fundamental process in producing long lasting results. The current and future evolution, in cosmetic surgery, is toward full achieved, but focused, natural, and minimally invasive surgical procedures in combination with effective and minimal risk techniques such as the botulinum toxin injections. To optimize the effect of the medical procedures, botulinum toxin should be injected three weeks before surgery. In addition botulinum toxin injections may optimize and prolong the effect of the surface procedures, as lasers, peels and fillers. This medicosurgical combination is one of the examples that best describes the evolution of plastic and aesthetic surgery in 2004.