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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

Figure showing how to measure middle and lower thirds of the face – at the levelof the zygoma and of the commissure of the lips, respectively
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f02: Figure showing how to measure middle and lower thirds of the face – at the levelof the zygoma and of the commissure of the lips, respectively

Mentions: Standardized photographs with the muscles relaxed and with patients grinding their teethwere taken before treatment and 2 weeks, 4 weeks, 12 weeks, and 24 weeks aftertreatment. Measurements for the width of middle and lower face were obtained using thephotographs, and a coefficient between middle and lower thirds of the face wasdetermined to represent the proportion between measures of the zygoma and of thecommissure of the lips. (Figure 2) Thiscoefficient was compared at the different followup times, with the purpose ofquantifying the probable increase in the proportion between middle and lower thirdsresulting from the thinning of the lower face caused by masseter atrophy. Questionnairesfor the assessment of pain, adverse effects, and satisfaction were applied, and thestandardized images were evaluated by three dermatologists with regard to the perceptionof facial thinning. The discomfort during the application of the toxin was assessed by anumerical scale from 0 to 10 (0=no pain and 10=the more severe pain everexperienced).


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)

Figure showing how to measure middle and lower thirds of the face – at the levelof the zygoma and of the commissure of the lips, respectively
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f02: Figure showing how to measure middle and lower thirds of the face – at the levelof the zygoma and of the commissure of the lips, respectively
Mentions: Standardized photographs with the muscles relaxed and with patients grinding their teethwere taken before treatment and 2 weeks, 4 weeks, 12 weeks, and 24 weeks aftertreatment. Measurements for the width of middle and lower face were obtained using thephotographs, and a coefficient between middle and lower thirds of the face wasdetermined to represent the proportion between measures of the zygoma and of thecommissure of the lips. (Figure 2) Thiscoefficient was compared at the different followup times, with the purpose ofquantifying the probable increase in the proportion between middle and lower thirdsresulting from the thinning of the lower face caused by masseter atrophy. Questionnairesfor the assessment of pain, adverse effects, and satisfaction were applied, and thestandardized images were evaluated by three dermatologists with regard to the perceptionof facial thinning. The discomfort during the application of the toxin was assessed by anumerical scale from 0 to 10 (0=no pain and 10=the more severe pain everexperienced).

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