BOTOX® injections (Botulinum Type A Neurotoxin)
for correction of forehead furrows, "crow's feet"
and for other newly discovered applications.

| Cosmetic lip surgery | | Cheek-lip groove correction |
| Scalp reduction | | Facial scar revision |,

BOTOX® injections for correction of forehead furrows, "crow's feet" and for other newly discovered applications.

Facial muscle contraction is one of the major causes of facial grooves and wrinkles. It has been observed that individuals who suffered one-sided facial paralysis showed a younger appearance on the paralyzed side. Most facial muscles play an important role in creating normal expression and physiological function. There are a few muscle groups however that can be spared and if they are inactivated, the unsightly skin changes caused by their action may be temporarily reversed and with repeated treatments permanently slowed down. These are in the forehead, particularly in the glabellar region (between the eyebrows), (Fig. 33a and c), and at the outer corners of the eyes - crow's feet.

Figure 33-a In repose - before injection (click image to enlarge)

Figure 33-b In repose - after injection (click image to enlarge)

Figure 33-c Frowning - before injection  (click image to enlarge)

Figure 33-d Frowning - after injection (click image to enlarge)

A substance known as BOTOX® blocks the transmission of the nerve impulse to the muscle and if injected into the muscle tissue will inactivate it from 4 to 8 months. Such treatment takes a few minutes and usually leaves patients without any side effects, (Fig. 33b and d). In very rare instances, the medication may affect a neighbouring muscle, eg. causing a slightly drooping eyelid, for two or three weeks. Recovery is always complete. Most recently, it has been documented that BOTOX® injections may be effective in the control of migraine headaches as well as it is effective in diminishing hyperhydrosis (excessive sweating).

A long term correction of the glabellar and forehead furrows can be achieved by an alternate method through surgical inactivation of these muscle groups, (Fig.36).

Figure 36-a (click image to enlarge)

Figure 36-b (click image to enlarge)

Figure 36-c (click image to enlarge)

Figure 36-d (click image to enlarge)

Cosmetic lip surgery

Various lip deformities, either congenital or after injury, can be improved by carefully planned minor surgery. Narrow lips can be made wider and wide lips, frequently seen in the black population, can be made narrower.

Some surgical techniques utilize an incision along the vermillion border. Others are associated with incisions inside the mouth. At times, an implant (soft tissue augmentation material) can be used alone, or in conjunction with other methods. This procedure requires, more than other operations, proper understanding of the technique and possible side effects on the part of the patient.

A liquid diet, through a straw, is required for a few days following surgery. Lipstick can be applied three days after the sutures have been removed. A non surgical lip augmentation, temporary or permanent, can be achieved with injectable materials - Collagen, Restylane, Hylaform, Artecoll. This particular method has recently gained significant popularity.

 

Cheek-lip groove correction

Pronounced cheek-lip grooves (naso-labial folds) create an impression of sadness and tiredness. They are also a sign of aging. Their correction is carried out in conjunction with a face lift operation. In some individuals it is possible to obtain a significant improvement without face lifting. A minor procedure utilizing local freezing and a small incision hidden in the nasal groove can be performed on an out-patient basis. A non-silicone material (Goretex), which has proven its safety and good compatibility with human tissue since the early 70's, is implanted deep under the skin, filling up the depressed area. Injectable materials, Collagen, Restylane, Hylaform, Artecoll, can also be used to achieve the same purpose.

 

Scalp reduction

Scalp reduction is one of the forms of treatment used to correct baldness. It is usually combined, at a later stage, with hair transplantation. Human skin is stretchable and allows for limited excision of the bald area of the scalp with advancing and joining of the remaining skin together. Such treatment will either completely remove the area of baldness or, more often, will reduce it making further hair transplantation less extensive and more effective.

The procedure is usually done under local anaesthesia with the patient sedated. It does not require admission to the hospital. You should shampoo your hair a few hours before the operation. A dressing will remain on your head for three days. After the dressing is removed, you can wash your hair again. Some variations in this routine are used and will be discussed during your pre-operative visit.

Facial scar revision

With the advent of newest laser technology, many facial scars can now be improved. The treatment requires two or three procedures staged six weeks to six months apart. Conscientious use of sunblock lotions and other prescribed skin preparations post operatively is essential to secure the best result.