Botulinum toxins are essential in global facial rejuvenation for relaxation of muscles of facial expression. The most widely studied botulinum toxin is Botulinum toxin A, which is primarily employed in the upper one-third portion of the face to address glabellar, forehead, and periocular rhytids. The lower one-third portion of the face is also gaining momentum with the treatment of the depressor angulii oriis and orbiculars oriis for meilolabial droop and perioral rhytis, respectively. Certain areas such as deep glabellar grooves, meilo – labial folds with droop, and perioral rhytids are best addressed in combination with dermal fillers. With many laser and light-source procedures, multiple treatments are necessary for optimal outcomes. The addition of botulinum toxin A on the same day of procedures such as photofacials and fractional resurfacing produces an immediate effect, allowing for greater patient satisfaction (Fig. 13.4). Morever, the timing and synergy for combining botulinum toxin A and photofacial and fractional laser procedures are ideal, as when the patient has completed the series of treatments over a span of three to five months, the effects of botulinum toxin A have worn off. There are a few studies that suggest a synergy between botulinum toxin A and photofacials. Split-face studies show an “enhanced” photofacial effect on patients treated with simultaneous intense pulsed light and botulinum toxin A, suggesting a synergy between the two modalities.
|
Before After Figure 13.4 Pre – and post-pulsed light and botulinum toxin A. |