SEBASTIEN GARSON M.D
This fact sheet was developed under the aegis of the French Society of Plastic Reconstructive and Aesthetic Surgery (SOF.CPRE) as an addition to your initial consultation, to try to answer all the questions you can ask yourself if you plan to use surgery baldness. The purpose of this document is to provide you with all the necessary and essential elements of information to help you make your decision with full knowledge of the facts. Also you is it advisable to read with the greatest attention.
• DEFINITION OBJECTIVES AND PRINCIPLES
Botulinum toxin is a substance that reduces the contraction of muscles acting at the neuromuscular junction (muscle relaxant action).
Since 1975, doctors use botulinum toxin to correct strabismus child, facial tics and uncontrollable blinking of the eye.
In France, the first authorization for placing on the market (AMM) occurred from 1990 to certain pathological indications (ophthalmology, ENT, functional rehabilitation, neurology) Regarding medical aesthetics, Dr. CARRUTHERS, ophthalmologist in Canada realized its first patients treated with botulinum toxin had fewer wrinkles around the eye than others. In 1990, a patient observer asked him to bring the other eye: this is the aesthetic indication was born.
Botulinum toxin under the name BOTOX received in the United States, the approval of the Food and Drug Administration (FDA) in 2002 for use in the treatment of frown lines or "frown lines."
In practice, the most classic indications of botulinum toxin in the field of aesthetic concern frown lines, forehead wrinkles and crow's feet.
The principle of botulinum toxin is the use of muscle relaxation properties of this product. The purpose is most often sought to reduce the action of the muscles located on the forehead and eyebrows, to mitigate both horizontal as vertical wrinkles wrinkles caused by the contraction of these muscles. Such use smoothes the skin relief and to obtain a rejuvenating effect by releasing muscle tension. On a broader perspective, we must know the position
eyebrows is ensured by a balance between two opposing forces, consisting of depressor muscles (located near the eyebrows), and levator muscle (the front muscle). The horizontal lines are due to the contraction of the frontalis muscle is reliever. The vertical frown wrinkles are caused by contraction of the depressor muscles.
The main objective of this treatment is to improve fine lines and wrinkles at rest and not to prevent muscle contraction so we judge the result mainly on the appearance of wrinkles at rest.
With regard to the balance between the depressor muscles and elevators, botulinum toxin by reducing the action of a muscle group, reduces wrinkles caused by the muscles but frees the action of antagonistic muscles: the goal is to treat the muscle balance and thereby achieve harmonization of the face.
• BEFORE THE INJECTION
No special preparation is necessary.
The day of injection, you do not need to be fasting. For women, there should be free to come up or removed before the injections. It is very important to minimize the risk of bleeding from treated areas to avoid taking aspirin for 15 days prior to injection and 15
days that follow.
Please observe the following cons-indications:
- Some neuromuscular diseases such as myasthenia gravis.
- Pregnancy and lactation: being pregnant, even a few days, imperatively requires to postpone the date of injections after pregnancy and discontinuation of any breastfeeding. It is therefore in doubt to perform the necessary tests and report the results to your doctor.
- Botulinum toxin is cons-indicated in patients with known hypersensitivity to botulinum neurotoxin A or serum albumin, and treatment with aminoglycosides (family of antibiotics which include such
the Amiklin and Gentalline). It is also necessary to observe a number of precautions:
- If you are treated (e) further injections of botulinum toxin for pathological spasms, if you have had an episode of paralysis of the muscles of the face, if you have a neuromuscular disease or disorder bleeding, you should report it to the practitioner who supports you for these injections of botulinum toxin. This will then determine with your doctor about whether injections about you and how to proceed if necessary. - If by the injections, you are taking anticoagulant medications or aspirin or antibiotics type or if you have any health problem (eg infection, flu, dental abscess ...) you must report it to your doctor before injection.
- In general, you should not hesitate to tell your doctor, any health problem encountered so that it appreciates the opportunity injections. In the same vein, you must tell him all your questions and include all the treatments you could be or do you still object.
• TYPE OF ANESTHESIA
No anesthesia is required.
The treatment will be achieved practitioner's office or clinic by the choices and habits of your doctor.
This treatment involves a series of injections in the face. The needle is thin, and the injections are usually not painful.
The duration of treatment is the order of a few minutes
AFTER THE INJECTION
During that two hours after the injections, it is recommended that you do not make intensive sport and not lie.
It should also avoid handling facial or massage supported for 24 hours after the session. It is very important to minimize the risk of bruising or bleeding treated during the fortnight preceding regions and fifteen days after the injections (to reduce the risk of product leakage to the peripheral muscles which could lead unwanted effects).
In addition, during the three days of the injections, it is highly desirable to contract the muscles injected three times a day for about 5 seconds per muscle.
Usually, the consequences of these injections are simple. Some brands are still a little swollen from 20 to 30 minutes and then disappear.
The patient (s) can resume their normal activities after the injections.
Some rare side effects can occur. They are transient.
It can be:
- Redness: localized redness at the injection site has been reported occasionally and rarely persists beyond 3 to 6 days.
- Bruising ("blue") of blue are rarely observed at the injection sites and can last a few days.
- Oedema: swelling, usually around the eyes, can be installed gradually in 4 to 5 days, then decrease in a few days to a few weeks.
- Sensitivity disorders: a feeling of tension or rigidity of the front of the mouth and neck, according to the injected areas, and a change in the sensitivity often associated with a feeling of cartonnement may persist for several days
- Fleeting eye or facial pain: such pain have been described in the injected so quite exceptional areas.
Nevertheless, in the aftermath of these injections, do not hesitate to contact your physician if you have any concerns.
• THE RESULT
The result is a reduction of wrinkles with a small conservation movements is obtained three to fifteen days after the injections.
Effects: the results are visible after a few days, but for about 15 days, the effects on the face can be variable (even unbalanced at times) before eventually stabilize.
The result after the first session lasts 3 to 6 months after which the injection can be repeated.
Frequency of injections: Injections should be performed several times at intervals of 3 to 6 months to get some stability results. From the second injection, the results can be more durable (6-8 months). It is then necessary to repeat the injections every 3 to 6 months.
However, it is recommended never closer than three months the injection sessions to avoid creating such resistance produced by a "vaccine effect".
The appearance of the result can be stabilized beyond three injections but in some cases it is necessary to use at least 8 to 10 injections to get some stabilization results.
Conversely, it should be noted that if the injections are stopped, the treated muscle regains its function before the injections.
• FAULTS OF THE RESULT
In some cases, localized imperfections (persistence of fine lines) can be seen without them are real complications. They depend on the surface appearance of the skin that may present even before the injections, an indelible "break" due to the length of the ride. There may also be insufficient and even asymmetric results: they are due to the fact that we have more or less powerful muscles and especially often asymmetrical.
These imperfections are usually handled by an additional injection of botulinum toxin, one month after injection. It should be noted that if additional localized injection may sometimes be desirable after an injection to improve the result, it should not be made before the 15th day because muscle balance (balance between muscle groups) take about 15 days to establish.
Asymmetry of the two sides of the face, as well as more pronounced wrinkles on one side than the other, the more often exist before injection. Finally the muscle responsible for the ride may be stronger on one side than the other. This is usually analyzed before injection. In such a case, the injections will be using a technique adapted and slightly different from one side to another. Despite this precaution, a residual asymmetry can persist and eventually may benefit from an additional injection.
The acts referred to aesthetic aim to make them happier and satisfy you in realistic proportions. Sometimes, however, the effect is not expected and achieved and that these actions increase instead of pre-existing psychological disorders. The post-injection experience can be extremely different from one patient to another, even with a similar aesthetic result. In the case of toxin Bolutique, rejuvenation is obtained in exchange for a reduction or disappearance of certain facial expressions. This aspect was evaluated with you to avoid the risk of disappointment especially if you are an actor, presenter, etc ...
• POSSIBLE COMPLICATIONS
Complications are very rare. Possible complications known to date are:
- Headache: they may be present at the waning of the first injection and disappear within a few hours to a few days.
- Ptosis eyebrows injection front can cause a slight drooping of the eyebrows. This descent is usually due to the fact that eyebrows were already in the down position before injection. This slight lowering of the eyebrows usually regresses within a few weeks.
- Ptosis of eyelids injection of frown lines can cause a partial collapse of the upper eyelid that can last 4-8 weeks. It is rare (less than 1% of cases), and always goes beyond a few weeks.
- Discomfort or smile and swallowing: injection into the lips can cause discomfort to smile or small abnormal movements. The injection in the neck can cause difficulty swallowing.
- Dry eyes: by reducing tear secretion may cause keratitis, especially in patients with contact lenses (it is, in this case, to ensure to hydrate the cornea).
- Paradoxical contraction of a muscle disorders and mimicry in the days following the injection, the treated muscles may have some paradoxical movements (spontaneous contractions) without gravity.
They are quite exceptional:
- Allergic reaction: rash, urticaria, systemic allergic reaction.
- Nausea, dizziness
- Fatigue, fever, flu syndrome
- Skin or dry mouth.
To these risks must add the unpredictability of life and aspects and finally, exceptional risks, or even inherent in any medical procedure unknown risks..
In total there should not overstate the risks, but just be aware that surgery, even seemingly simple, still a small share of hazards. The use of a qualified Plastic Surgeon ensures that it has the training and knowledge required to avoid these complications, or effectively treat if jurisdiction.
These are the pieces of information that we wanted to bring you in addition to the consultation. We recommend that you keep this document, read it again after the consultation and reflect "a clear head." This reflection may raise new questions for which you wait for additional information. We are available to talk during the next consultation, or by phone, or even on the day of surgery when we meet in any way before anesthesia.
Phone : + 33344282959
7 impasse de la Passerelle 60300 SENLIS
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