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Cosmetic Uses of Botulinum Neurotoxin Type A
An Overview
Andrew Blitzer, MD,DDS;
William J. Binder, MD
Arch Facial Plast Surg. 2002;4:214-220.
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INTRODUCTION
Clostridium botulinum produces 7 serologically distinct toxins that are designated A, B, C, D, E, and F. They all have similar structure (a dichain with a disulfide bond) and a molecular weight of about 150 d. The light chain is a zinc-dependent metalloprotease, in which the substrate is one of the fusion proteins responsible for docking and ultimately exocytosis of the acetylcholine-containing vesicle. Each serotype light chain cleaves a specific residue of one of these proteins, thus preventing the formation of this docking complex and hence, preventing neurotransmitter exocytosis.1-2
Long-term exposure to toxin causes reversible denervation atrophy, and reinnervation occurs through noncollateral sprouting followed by repair of the docking protein, which was cleaved. Clinically, the weakening effects of botulinum neurotoxin (BTX) type A last about 3 to 4 months. Other serotypes have shorter duration of effect.1-2
The potency of commercially available toxin is . . . [Full Text of this Article]
RISKS AND ADVERSE EFFECTS
COSMETIC INDICATIONS
TECHNIQUE
SPECIFIC INJECTION SITES
Glabellar Lines Horizontal Forehead Lines Brow Position Crow's-Feet Lines Nasal Scrunch or "Bunny" Lines Nasolabial Lines "Marionette" Lines "Lipstick" Lines Peau d'orange or "Popply Chin" Correction Platysmal Bands
POSTINJECTION FOLLOW-UP
From Columbia University and the New York Center for Voice and Swallowing Disorders, New York (Dr Blitzer), and the Department of Head and Neck Surgery, University of California, Los Angeles (Dr Binder). Drs Blitzer and Binder have received consultant fees from Allergan Inc, Irvine, Calif, and Dr Blitzer has received research grants from Allergan Inc.
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