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A. Erian

Fig. 47.10 (a–c) Mendes needles and serdev needles for threading

47.8.2 Thread Lift Risks

These include bruising, swelling, and tenderness. Additional potential complications of a thread lift are puckering where the barb is pulling, visibility of the blue thread through the skin, and threads poking through the skin. A thread lift, while less invasive than a face-lift, is nonetheless surgery with its inherent risks. The most serious complication is injury to the temporal branch of the facial nerve which can get caught in the treads, and this could be temporary or permanent.

47.9Botox (Chemodenervation with Botulinum Toxin)

Botulinum toxin, the most lethal poison known to mankind has provided hope and relief to countless victims with certain neurological conditions (Fig. 47.11). More recently, its application for cosmetic use has been established. In particular, it is of prime importance in forehead rejuvenation. It is known to work on

a

c

b

 

 

Development

 

 

Botulism by clostridium

 

Approved in

Botulinum 1700-1800

 

59 countries

 

 

 

 

E Shantz et al (1944)

BOTOX

Biological weapon

1989 FDA approval

analysis

 

 

 

 

 

 

 

Clinical development

1969 medical use

Cervical dystonia &

evaluation

Other uses

Type A 900 KD

First clinical

Complex purification

 

Development A Scott

Strabismus, Blepharospasm

Fig. 47.11 Development of Botox

the neuromuscular junction through a blocking process (Fig. 47.12).

In forehead rejuvenation, the basic applications work well to improve the following areas:

ss Horizontal forehead lines (Figs. 47.13 and 47.14) ss Glabellar frown lines (Fig. 47.15)

ss The results of lateral and medial brow lifts ss Crow’s feet (Fig. 47.16)

47 Endobrow Lift

535

Fig. 47.12 Mechanism of

a

action of botulinum toxin. (a)

 

Binding. (b) Internalization.

 

(c) Blockade. (d)

 

Reinnervation

 

c

a

b

d

b

Fig. 47.13 Sites of injection of Botox for (a) horizontal and (b) multiple frown lines

a

b

Fig. 47.14 Partial elimination of frontalis muscle by Botox. (a) Before treatment. (b) After treatment