Ensayo con lidocaina 1% previo a la inyección de Botox (MR), es útil para predecir resultados...
Facial Mapping With Lidocaine Injection Allows Better Placement of Neurotoxin
In over a decade of teaching residents and colleagues the technique and science of injecting fillers and toxins, one of the most difficult aspects to teach has been the art of placement of toxin injections.
Unlike fillers, where one can see the immediate corrective results after injection, toxin injections merely leave a wheal. Filler injections into a person or into a SIMSKIN training model allow the novice to experience the feeling of injecting material and to see the results of placement. On the other hand, the wheals left behind after injection of toxin do not reflect the functional and aesthetic results of the injection. Similarly, the complications associated with misplacement are only known at a later time after the toxin takes effect.
The clever technique of using 1% plain lidocaine to simulate the injection and the response serves as a proxy to injection of the actual toxin. This allows the injector to see a simulation of the expected result of injection in a nearly immediate fashion although the effects last only a few hours. We look forward to using this as a safe and effective training and self-assessment tool. Additionally, for patients who are hesitant to undergo a toxin treatment, a simulated treatment with lidocaine may allay their fears since they can see the expected results immediately.
Abstract
BACKGROUND
Botulinum-derived neurotoxins have become a substantial tool in dermatologists' armamentarium for facial/neck rejuvenation. Current literature discusses anatomical "danger zones" to avoid during neurotoxin injection to prevent brow ptosis, blepharoptosis, and lower facial ptosis.
OBJECTIVE
The aim of this study was to determine whether lidocaine 1% local anesthetic can be used to predict botulinum toxin treatment outcomes and prevent adverse effects of unwanted paralysis.
MATERIALS AND METHODS
One percent lidocaine was drawn up using BD ultra-fine 31 G (5/16″), 0.5-mL insulin syringes in the same quantity that would be drawn up for neurotoxin placement. The patient's face was cleansed and mapped; 0.1 mL of 1% lidocaine was injected × 5 sites in the glabella; and 3 sites were injected with 0.05 mL in the frontalis. The patient was assessed after 10 minutes.
RESULTS
Improvement in frontalis and glabellar rhytides was appreciated, with noted "spocking" of the lateral brows. This technique allowed the authors to visualize the need for placement of toxin more laterally with eventual successful predictive placement for neurotoxin.
CONCLUSION
This technique of using local 1% lidocaine allows the practitioner to devise a neurotoxin distribution map tailored for each patient to limit unwanted paralysis from improper neurotoxin placement.
Copyright © 2018 Elsevier Inc. All rights reserved.
0 Comments:
Post a Comment
Subscribe to Post Comments [Atom]
<< Home