By Kyle K Seo

This publication, containing greater than four hundred pictures and illustrations, offers useful guidance for the beauty use of botulinum toxin kind A (BTA) in Asians. the variations in BTA therapy of Asians and Caucasians with appreciate to acceptable dose, injection equipment, anatomic value, and symptoms are basically defined. it's defined how the optimum dose and injection websites for the therapy of wrinkles range from the information recommended in North the USA and Europe. exact attention is given to the swiftly increasing function that BTA therapy is taking part in in facial and physique contouring according to leveraging the mechanism of disuse muscle atrophy. Examples which are relatively proper in Asians comprise therapy of hypertrophy of the masseter and temporalis muscle mass and calf muscle aid. additional chapters are dedicated to using BTA within the therapy of hyperhidrosis and the intradermal injection of BTA. The booklet can be a good source for all dermatologists, plastic surgeons, beauty Physicians, and different clinicians who hire BTA in Asian sufferers.

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Pure neurotoxin products without complexing proteins would be better consid- ered in such cases in terms of reducing protein load. Frequent antigen exposure with weekly or biweekly injections, which is performed in some clinics as a marketing, should also be avoided. 6 Safety BoNT-A, like many drugs, may occasionally cause adverse effects such as headache, vertigo, allergic reaction, etc. However, the safety of BOTOX®, one of the representative BoNT-A products, is well established and the incidences of adverse effects have been extremely low since first approved in 1989.

BoNT-A injections are not generally advised for the treatment of dynamic wrinkles of the nasolabial folds, marionette lines, and lines on the zygomatic and cheek areas which can be seen in the smile of George Clooney. This is due to the fact that injections around these areas cause paralysis of the zygomaticus major which cause weird smiles. Although we can inject BoNT-A for the treatment of the nasolabial folds with much caution in selective cases, this is likely to result in an awkward smile like that of Jack Nicholson’s Joker character in the 1989 Batman film due to paralysis of the lip elevator muscles.

Commercialized BoNT products are purified to the nano level (one-billionth of a gram). They have a pharmacological effect for relaxing the injected muscles only locally without systemic adverse effects as long as the recommended dose is administered. Typical doses of BoNT-A for cosmetic purposes, therefore, pose no danger to humans.  This corresponds to around 30 vials of 100 U BOTOX®. In short, injection of BoNT-A 100 U or less for cosmetic purposes such as wrinkle removal and square jaw contouring will not be harmful.

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