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Lower facial remodeling with botulinum toxin type A for the treatment of masseter hypertrophy.

Klein FH, Brenner FM, Sato MS, Robert FM, Helmer KA - An Bras Dermatol (2014 Nov-Dec)

Bottom Line: Observed adverse effects were masticatory fatigue, smile limitation, and smile asymmetry.Smile limitation had a higher incidence compared to that reported in the literature and may result from risorius muscle blockage caused by toxin dissemination.Despite its side effects, 80% of the patients would like to repeat the treatment.

View Article: PubMed Central - PubMed

Affiliation: Private practice particular - Criciúma (SC), Brazil, Criciúma, SC, Brazil.

ABSTRACT

Background: Masseter hypertrophy has been treated with botulinum toxin injections because of esthetic complaints especially in Asians.

Objectives: The goal of the present study was to evaluate the efficacy of abobotulin toxin use in masseter hipertrophy treatment in Brazilians.

Methods: Ten Brazilian female patients with masseter hypertrophy were subjected to injections of 90U of abobotulinum toxin A applied on each side respecting the safety zone stabilished in literature and were followed up for 24 weeks.

Results: When analyzing the coefficients between measures of middle and lower third of the face obtained from standardized photographs, an increase was observed, with statistical significance at 2 weeks (p=0.005) and 12 weeks (p=0.001). The progression of lower third reduction was 3.94%, 5.26%, 11.99%, and 5.47% (2, 4, 12, and 24 weeks respectively). All patients showed improvement in bruxism after treatment. Observed adverse effects were masticatory fatigue, smile limitation, and smile asymmetry.

Conclusion: The use of abobotulinum toxin A for masseter hypertrophy is effective in Brazilians and reached its maximum effect of facial thinning at 12 weeks. Smile limitation had a higher incidence compared to that reported in the literature and may result from risorius muscle blockage caused by toxin dissemination. Despite its side effects, 80% of the patients would like to repeat the treatment.

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Related in: MedlinePlus

Delimitation of the safe area – a line from around the lower portion of the ear tothe angle of the mouth – and delimitation of the anterior and posterior portionsof the muscle through muscle palpation with patients grinding their teeth. Sitesof toxin application marked within the safe area.
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f01: Delimitation of the safe area – a line from around the lower portion of the ear tothe angle of the mouth – and delimitation of the anterior and posterior portionsof the muscle through muscle palpation with patients grinding their teeth. Sitesof toxin application marked within the safe area.

Mentions: The ultimate objective of the several authors who studied the topic is also different.Some of them aim to achieve muscle atrophy by reapplying the toxin based on patient'scomplaint, but other authors recommend performing monthly applications of the toxinuntil there is no muscle activity, with frequent booster doses to prevent musclestrength to recover by more than 30%.2,11 With regard to the injection site, thereis a trend to work on a safe area established after careful anatomical observation andperception of adverse effects.9,13,19 This area is limited to an area from the lower implantation of theear to the mouth angle. The anterior edge of the masseter muscle was determined bypalpation after the patients are asked to grind their teeth (Figure 1).


Lower facial remodeling with botulinum toxin type A for the treatment of masseter hypertrophy.

Klein FH, Brenner FM, Sato MS, Robert FM, Helmer KA - An Bras Dermatol (2014 Nov-Dec)

Delimitation of the safe area – a line from around the lower portion of the ear tothe angle of the mouth – and delimitation of the anterior and posterior portionsof the muscle through muscle palpation with patients grinding their teeth. Sitesof toxin application marked within the safe area.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230655&req=5

f01: Delimitation of the safe area – a line from around the lower portion of the ear tothe angle of the mouth – and delimitation of the anterior and posterior portionsof the muscle through muscle palpation with patients grinding their teeth. Sitesof toxin application marked within the safe area.
Mentions: The ultimate objective of the several authors who studied the topic is also different.Some of them aim to achieve muscle atrophy by reapplying the toxin based on patient'scomplaint, but other authors recommend performing monthly applications of the toxinuntil there is no muscle activity, with frequent booster doses to prevent musclestrength to recover by more than 30%.2,11 With regard to the injection site, thereis a trend to work on a safe area established after careful anatomical observation andperception of adverse effects.9,13,19 This area is limited to an area from the lower implantation of theear to the mouth angle. The anterior edge of the masseter muscle was determined bypalpation after the patients are asked to grind their teeth (Figure 1).

Bottom Line: Observed adverse effects were masticatory fatigue, smile limitation, and smile asymmetry.Smile limitation had a higher incidence compared to that reported in the literature and may result from risorius muscle blockage caused by toxin dissemination.Despite its side effects, 80% of the patients would like to repeat the treatment.

View Article: PubMed Central - PubMed

Affiliation: Private practice particular - Criciúma (SC), Brazil, Criciúma, SC, Brazil.

ABSTRACT

Background: Masseter hypertrophy has been treated with botulinum toxin injections because of esthetic complaints especially in Asians.

Objectives: The goal of the present study was to evaluate the efficacy of abobotulin toxin use in masseter hipertrophy treatment in Brazilians.

Methods: Ten Brazilian female patients with masseter hypertrophy were subjected to injections of 90U of abobotulinum toxin A applied on each side respecting the safety zone stabilished in literature and were followed up for 24 weeks.

Results: When analyzing the coefficients between measures of middle and lower third of the face obtained from standardized photographs, an increase was observed, with statistical significance at 2 weeks (p=0.005) and 12 weeks (p=0.001). The progression of lower third reduction was 3.94%, 5.26%, 11.99%, and 5.47% (2, 4, 12, and 24 weeks respectively). All patients showed improvement in bruxism after treatment. Observed adverse effects were masticatory fatigue, smile limitation, and smile asymmetry.

Conclusion: The use of abobotulinum toxin A for masseter hypertrophy is effective in Brazilians and reached its maximum effect of facial thinning at 12 weeks. Smile limitation had a higher incidence compared to that reported in the literature and may result from risorius muscle blockage caused by toxin dissemination. Despite its side effects, 80% of the patients would like to repeat the treatment.

Show MeSH
Related in: MedlinePlus