Advanced Techniques in Dermatologic Surgery (Basic and by Goldman M.P. (Editor), Weiss R. (Editor)

By Goldman M.P. (Editor), Weiss R. (Editor)

Compiled by way of professional specialists within the box, this reference presents transparent tips at the simple ideas, systems, and issues excited by complicated dermatologic surgery-offering distinctive assurance of filling ingredients, fats move ideas, and the most recent laser applied sciences.

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Extra info for Advanced Techniques in Dermatologic Surgery (Basic and Clinical Dermatology)

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Injecting 2 U of BTX-A into the lower pretarsal orbicularis will relax the palpebral aperture at rest and while smiling (26). In a study of 15 women, Flynn et al. 5 cm from the lateral canthus, each 1 cm apart (27). 9 mm at full smile, and results were more dramatic in the Asian eye (Fig. 2). However, be careful to select patients who have had a good preinjection snap test and who have not had lower eyelid ablative resurfacing or infralash blepharoplasties without a coexisting canthopexy to support the normal position of the lower eyelid.

N Engl J Med 1997; 336:1197–1201. 41. Engberg G, Danielson K, Henneberg S, Nilsson A. Plasma concentrations of prilocaine and lidocaine and methaemoglobin formation in infants after epicutaneous application of a 5% lidocaine-prilocaine cream (EMLA). Acta Anaestheiol Scand 1987; 31(7):624–628. 42. Eaglstein FN. Chemical injury to the eye from EMLA cream during erbium laser resurfacing. Derm Surg 1999; 25(7):590–591. 43. McKinlay JR, Hofmeister E, Ross EV, Mac Allister W. EMLA cream-induced eye injury.

Although one of the greatest concerns with the use of BTX-A is the formation of neutralizing antibodies, the overall risk in using BTX-A at recommended doses for neurologic applications is low (less than 5%), and injecting the lowest effective doses, with the longest feasible intervals between injections, will minimize the potential for immunogenicity (1). Lack of effectiveness of BTX-A secondary to the development of immunologic resistance is exceedingly rare in cosmetic patients, and must be distinguished from a much more common degree of resistance, associated with the need for increased doses and probably not due to immunologic mechanisms.

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