Immediate treatment of botulinum toxin type A-induced brow ptosis with polydioxanone cog thread insertion

Abstract

Background: Botulinum toxin is most commonly used as a safe cosmetic injectable to improve dynamic wrinkles. However, side effects still occur. Among them, brow ptosis is known to occur relatively infrequently. The condition is self-limiting; however, for about 3 months post-injection, the patient must endure related uncomfortable symptoms. Several methods have been recommended to prevent this complication; however, no treatment has been developed to improve such symptoms instantly. Currently, various processed threads, such as polydioxanone (PDO), are widely used for facial rejuvenation; PDO thread is bio-absorbable.Objective: The authors performed brow lifting using a cogged PDO thread to improve uncomfortable symptoms associated with brow ptosis. Methods:In total, 14 PDO threads with multi-bidirectional cogs (two 1.0 threads, with lengths of 9.0 cm each, and twelve 1.0 threads, with lengths of 6.0 cm each) were placed in 7 rows, which were inserted into the superficial fat layer and deep fat layer (dual plan insertion) separately, at approximately 1.0-cm intervals.Results: Following the use of the thread, the positions of the left and right eyebrows were observed to have slightly increased by an average of 1.43±0.65 mm and 1.7±0.9 mm after two weeks, respectively; the patients indicated a high degree of satisfaction with immediate improvement of the uncomfortable symptoms. Conclusion:It is suggested that PDO thread brow lifting would be a reliable procedure to immediately treat botulonum-toxin induced brow ptisos noninvasively.

Blepharoptosis treatment as a complication due to botulinum toxin application

“…The authors themselves report that the best solution lies in waiting for the time to lose the effects of the toxin, but they used this technique due to the multiple complaints of the patient. In cases of eyebrow ptosis, polydioxanone threads can be used to pull the region and heal ptosis [20], but due to the upper eyelid anatomy, there is no report in the literature on blepharoptosis resolution using traction threads. Much is said about the use of other therapies to reverse botulinum toxin.…”

Periorbital changes in patients with Poly(Lactic Acid/ Caprolactone) threads for brow augmentation

“…In younger patients, Botox injection will generally increase the ptotic brow by 1 to 2 mm. Botox with polydioxanone threads can also significantly improve brow position [17]. Dermal and subcutaneous filler substances, such as hyaluronic acid products and biostimulators, act as tissue expanders to provide structural support for soft tissue augmentation.…”