android barcode scanner api java COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE in .NET framework

Creating Quick Response Code in .NET framework COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE

COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE
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Perioral Lines
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Many factors are implicated in the formation of perioral lines Smoking, photoaging, loss of subcutaneous tissue in the lower face, and the purse string-like action of the orbicularis oris muscles are the most important causes BTX-A injection is usually reserved for deep perioral lines worsened with muscular
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FIGURE 22-16 Forehead with eyebrows elevated prior to injection of botulinum toxin lower facial muscles to BTX-A is greater than upper facial muscles Moreover, it has been established that the lower facial muscles will have a longer-lasting response to BTX-A than upper facial musculature The dose for the lower muscles therefore needs to be adjusted to the muscle size and patient gender to be approximately half or onethird the dose injected in the upper facial muscles Upper Gum Show The levator labii superioris alaeque nasi muscle retracts the upper lip In some individuals, this muscle is overactive and pulls the lip back excessively, allowing visualization of the upper gums and upper incisors Injecting 1 to 2 U into the levator labii superioris alaeque nasi muscle on each side of the bony nasal prominence will slightly drop the lip, preventing the upper gum show This procedure works better in young patients because it causes vertical elongation of the lip This can be used in combination with fillers such as CosmoPlast in the vermilion border to prevent the elongated lip (Fig 22-28)
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Melomental Folds
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The melomental folds are also called marionette lines They extend from the downturned corner of the mouth to the FIGURE 22-17 Forehead with eyebrow elevated after injection of botulinum toxin Note that lower forehead wrinkles are still present However, they are not apparent when eyebrows are not elevated
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FIGURE 22-18 Before (A) and after (B) Botox injections
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pursing of the lips The dosage is dependent on the depth of lines but generally 1 U of BTX-A injected into each site with a total of 2 U per half of the upper lips The middle upper lip should be avoided in patients wanting to retain their cupid bow It is critical to measure the placement on the upper lips first so that the sides are treated in exactly the same spot to preserve symmetry (Fig 22-29) The best results occur when BTX is combined with laser resurfacing or lip fillers to enhance the vermillion border and smooth the surface of the skin
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Mentalis Muscle and Chin Puckering
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Relaxing the hyperkinetic muscle fibers of the chin and the mentalis muscle with BTX-A can reduce and eliminate chin puckering (Fig 22-30) A single dose of 4 to 6 U of BTX-A placed in the exact center of the point of the chin is effective51 An overdose in this area can result in the inability to approximate the lower lips tightly against the teeth, ultimately leading to involuntary dribbling from the lip when drinking or drooling from the corners of the mouth54
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CHAPTER 22 BOTULINUM TOXIN
FIGURE 22-19 Before (A) and after (B) Botox injections to the forehead, glabella, and crow s feet
Neck Lines and Platysma
Brandt and Bellman were the first to report using BTX to treat aging of the neck55 Platysmal bands and neck vertical lines represent an accurate gauge of chronological age specifically for those people with exaggerated outdoor sun exposure Separation of the platysma anteriorly occurs with aging, resulting in banding or turkey neck Vertical platysmal bands may be successfully treated with BTX-A The extended or marked platysmal bands are grasped between the thumb and index fingers and the needle is vertically inserted into the muscle band The dose is usually 2 to 4 U spaced 4 cm apart with an overall cumulative dose of 8 to 12 U per band and a total maximum in the neck of 25 to 30 U Because of the nature of the muscle and the site of injection, complications such as dysphagia and dysphonia can be encountered56 Patients should be warned about the possibility of such untoward effects NEFERTITI LIFT The platysma muscle pulls downward with age, leading to jowl formation and frequent rhytides Jawline redefinition with neurotoxin has not been widely exposed in the literature and there exists a discrepancy in the exact dosing and techniques to best define this area A technique described
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