Botulinum Toxins in Clinical Aesthetic Practice

297 Pages·2011·25.79 MB·English

by  Benedetto, Anthony V.

Botulinum Toxins in Clinical
Aesthetic Practice
SERIES IN COSMETIC AND LASER THERAPY
Series Editors
David J. Goldberg, Nicholas J. Lowe, and Gary P. Lask
Published in association with the Journal of Cosmetic and Laser Therapy
David J. Goldberg, Fillers in Cosmetic Dermatology, ISBN 9781841845098
Philippe Deprez, Textbook of Chemical Peels, ISBN 9781841842954
C. William Hanke, Gerhard Sattler, Boris Sommer, Textbook of Liposuction, ISBN 9781841845326
Paul J. Carniol, Neil S. Sadick, Clinical Procedures in Laser Skin Rejuvenation, ISBN 9780415414135
David J. Goldberg, Laser Hair Removal, Second Edition, ISBN 9780415414128
Benjamin Ascher, Marina Landau, Bernard Rossi, Injection Treatments in Cosmetic Surgery, ISBN 9780415386517
Avi Shai, Robert Baran, Howard I. Maibach, Handbook of Cosmetic Skin Care, Second Edition, ISBN 9780415467186
Jenny Kim, Gary Lask, Comprehensive Aesthetic Rejuvenation: A Regional Approach, ISBN 9780415458948
Neil Sadick, Paul Carniol, Deborshi Roy, Luitgard Wiest, Illustrated Manual of Injectable Fillers, ISBN 9780415476447
Paul Carniol, Gary Monheit, Aesthetic Rejuvenation Challenges and Solutions: A Global Perspective, ISBN 9780415475600
Neil Sadick, Diane Berson, Mary P. Lupo, Zoe Diana Draelos, Cosmeceutical Science in Clinical Practice, ISBN 9780415471145
Anthony Benedetto, Botulinum Toxins in Clinical Aesthetic Practice, Second Edition, ISBN 9780415476362
Robert Baran, Howard I. Maibach, Textbook of Cosmetic Dermatology, Fourth Edition, ISBN 9781841847009
David J. Goldberg, Alexander L. Berlin, Disorders of Fat and Cellulite, ISBN 9780415477000
Kenneth Beer, Mary P. Lupo, Vic A. Narurkar, Cosmetic Bootcamp Primer: Comprehensive Aesthetic Management,
ISBN 9781841846989
Walter P. Unger, Ronald Shapiro, Robin Unger, Mark Unger, Hair Transplantation, Fifth Edition, ISBN: 9781616310066
Botulinum Toxins in Clinical
Aesthetic Practice
Second Edition
Edited by
Anthony V. Benedetto DO FACP
Clinical Associate Professor of Dermatology
Department of Dermatology
University of Pennsylvania School of Medicine
Philadelphia, Pennsylvania, USA
and
Dermatologic SurgiCenter
Philadelphia, Pennsylvania, USA
First published in 2006 by Taylor & Francis
This edition published in 2011 by Informa Healthcare, Telephone House, 69-77 Paul Street, London EC2A 4LQ, UK.
Simultaneously published in the USA by Informa Healthcare, 52 Vanderbilt Avenue, 7th Floor, New York, NY 10017, USA.
© 2011 Informa UK Ltd, except as otherwise indicated.
No claim to original U.S. Government works.
Reprinted material is quoted with permission. Although every effort has been made to ensure that all owners of copyright material
have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions
brought to our attention.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise, unless with the prior written permission of the publisher or
in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting
l imited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP, UK, or the Copyright
Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, USA (http://www.copyright.com/ or telephone [phone]).
Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation
without intent to infringe.
This book contains information from reputable sources and although reasonable efforts have been made to publish accurate infor-
mation, the publisher makes no warranties (either express or implied) as to the accuracy or fitness for a particular purpose of the
information or advice contained herein. The publisher wishes to make it clear that any views or opinions expressed in this book by
individual authors or contributors are their personal views and opinions and do not necessarily reflect the views/opinions of the
publisher. Any information or guidance contained in this book is intended for use solely by medical professionals strictly as a supple-
ment to the medical professional’s own judgement, knowledge of the patient’s medical history, relevant manufacturer’s instructions
and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages,
procedures, or diagnoses should be independently verified. This book does not indicate whether a particular treatment is appropriate
or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own pro-
fessional judgements, so as appropriately to advise and treat patients. Save for death or personal injury caused by the publisher’s
negligence and to the fullest extent otherwise permitted by law, neither the publisher nor any person engaged or employed by the
publisher shall be responsible or liable for any loss, injury or damage caused to any person or property arising in any way from the
use of this book.
A CIP record for this book is available from the British Library.
ISBN-13: 978-0-415-47636-2
Orders may be sent to: Informa Healthcare, Sheepen Place, Colchester, Essex CO3 3LP, UK
Telephone: [phone]
Email: [email protected]
Website: http://informahealthcarebooks.com/
For corporate sales please contact: [email protected]
For foreign rights please contact: [email protected]
For reprint permissions please contact: [email protected]
Typeset by Exeter Premedia Services Private Ltd., Chennai, India
Printed and bound in the United Kingdom
Dedication
This book is dedicated to those physicians who are committed to providing patients with the best medical care using state-of-the-art techniques;
and to the coauthors who have contributed valuable time and expertise in the creation of this book. Lastly, to Dianne, whose encouragement and
loving support permitted me to accomplish that which at times has appeared insurmountable.

Contents
List of contributors viii
Foreword ix
Alastair Carruthers
Preface x
Anthony V. Benedetto
Prologue The search for beauty: historical, cultural, and psychodynamic trends xi
Caroline S. Koblenzer
1 Pharmacology, immunology, and current developments 1
K. Roger Aoki
2 Facial anatomy and the use of botulinum toxin 15
James M. Spencer
3 Cosmetic uses of Botulinum toxin A in the upper face 24
Anthony V. Benedetto
4 Cosmetic uses of Botulinum toxin A in the mid face 101
Anthony V. Benedetto
5 Cosmetic uses of Botulinum toxin A in the lower face, neck, and upper chest 140
Anthony V. Benedetto
6 Skin resurfacing with Microbotox and the treatment of keloids 190
Woffles T. L. Wu
7 Facial and lower limb contouring 206
Woffles T. L. Wu
8 Botulinum toxin type A treatment for Raynaud’s phenomenon and other novel dermatologic therapeutic applications 223
Irèn Kossintseva, Benjamin Barankin, and Kevin C. Smith
9 Botulinum toxins-A other than BOTOX® 234
Gary D. Monheit
10 Botulinum toxin B 240
Neil S. Sadick and Yekaterina Kupava
11 Botulinum toxin in the management of focal hyperhidrosis 248
Dee Anna Glaser
12 Medicolegal considerations of cosmetic treatment with botulinum toxin injections 263
David J. Goldberg
Appendix 1 Muscles of facial expression 267
Appendix 2 The preparation, handling, storage, and mode of injection
of onabotulinumtoxinA 272
Appendix 3 Patient treatment record 274
Appendix 4 Informed consent for the treatment of facial and body wrinkles with BoNTA 275
Appendix 5 Side-effects and contraindications to BoNTA injections 276
Index 279
vii
List of contributors
K. Roger Aoki PhD Irèn Kossintseva MD
Vice President, Neurotoxins Research Program, Department of Biological University of British Columbia, Vancouver, British Columbia, Canada
Sciences, Allergan, Inc., Irvine, California, USA
Yekaterina Kupava
Anthony V. Benedetto DO FACP Sadick Research Group, New York, New York, USA
Clinical Associate Professor of Dermatology, Department of
Dermatology, University of Pennsylvania School of Medicine,
Gary D. Monheit MD
and Medical Director, Dermatologic SurgiCenter, Philadelphia,
Monheit Dermatology Associates, South Birmingham, Total Skin
Pennsylvania, USA
& Beauty Dermatology Center, and Clinical Associate Professor,
Department of Dermatology, Department of Ophthalmology, University
Benjamin Barankin MD FRCP of Alabama at Birmingham, Birmingham, Alabama, USA
Dermatologist, The Dermatology Centre, Toronto, Ontario, Canada
Neil S. Sadick MD
Dee Anna Glaser MD Sadick Dermatology & Aesthetic Surgery, New York, New York, USA
Professor & Vice Chairman, Director Cosmetic & Laser Surgery,
Department of Dermatology, Saint Louis University School of Medicine, Kevin C. Smith MD FACP FRCPC (Dermatology)
Saint Louis, Missouri, USA Dermatologist, Niagara Falls Dermatology and Skin Care Centre,
Niagara Falls, Ontario, Canada
David J. Goldberg MD
JD Director, Skin Laser & Surgery Specialists of NY/NJ, New Jersey, James M. Spencer MD MS
Clinical Professor of Dermatology and Director of Laser Research, Clinical Professor of Dermatology, Department of Dermatology, Mount
Mount Sinai School of Medicine, New York, and Adjunct Professor of Sinai School of Medicine, New York, New York, and Medical Director,
Law, Fordham University School of Law, New York, New York, USA Spencer Dermatology & Skin Surgery Center, Saint Petersburg,
Florida, USA
Caroline S. Koblenzer MD
Clinical Professor of Dermatology, Department of Dermatology, Woffl es T. L. Wu MD
University of Pennsylvania School of Medicine, Philadelphia, Woffl es Wu Aesthetic Surgery & Laser Centre, Camden Medical Centre,
Pennsylvania, USA Singapore
viii
Foreword
It is an honor and a pleasure to write a Foreword for the new edition of Dr. Benedetto is a well-known expert in both dermatology and
Dr. Benedetto’s book Botulinum Toxins in Clinical Aesthetic Practice. a esthetic medicine. His especial area of expertise is the surgical or pro-
The first edition of this book, under the title Botulinum Toxin in Clini- cedural side of dermatology and he has spent many years perfecting
cal Dermatology was very well received and much admired. However, skin cancer treatment techniques and treating many thousands of skin
time has moved on and it is time to update the information which was cancer patients successfully. However, he has also achieved a deserved
available in the earlier book. The amount of information about the reputation in the cosmetic world, especially in the use of botulinum
botulinum n eurotoxins and especially about their cosmetic use has toxin. For many years he has been interested in the application of botu-
increased dramatically in the last few years with new papers being pub- linum toxin, not just to the upper face but also to the lower face and
lished daily. It is important to have a synthesis of this new information especially in individuals with facial asymmetry.
and its integration into the previously available knowledge. In addi- This elegant book is appropriate for all who are interested in this
tion, the range of individuals who are administering the toxin has field of knowledge. It will be appreciated not only by health care
increased significantly. Hence the new edition of this book. workers who administer the toxin but also by those who enjoy its
I have particularly appreciated Dr. Benedetto’s selection of his co- beneficial effects. The former will improve their skill in the use of the
authors; each is an acknowledged expert in the area in which they are material and the latter will learn more about how botulinum toxin
writing. Dr. Benedetto has written many of the “core” chapters himself can be used for good. I encourage all of you who are interested in this
but has called on the assistance of other experts in important topics topic to read this excellent book.
such as cosmetic indications which are less used in North America.
Readers will be delighted by the clear anatomic diagrams and apprecia- Alastair Carruthers
tive of the clear advice on the handling and dilution of the currently Vancouver, Canada
available toxins—subjects which have caused much confusion. September 2010
ix