International consensus recommendations on the aesthetic usage of botulinum toxin type A (Speywood Unit) – part I: upper facial wrinkles

Ascher, Benjamin; Talarico, Sérgio; Cassuto, Daniel; Escobar, S; Hexsel, Dóris; Jaén, Pedro; Gd, Monheit; Rzany, Berthold; Viel, Maurizio

doi:10.1111/j.1468-3083.2010.03631.x

Cited by 98 publications

(77 citation statements)

References 32 publications

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“…Type A toxin is also the serotype most commonly used in the pharmaceutical industry (16) to treat a wide variety of neuronal disorders (27). In addition, type A toxin is used as a cosmetic treatment to smooth wrinkles by paralyzing facial muscles (2,3) . Within serotype A, five different subtypes have been identified (A1, A2, A3, A4, and A5) (7,9,14).…”

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confidence: 99%

Purification and Characterization of a Novel Subtype A3 Botulinum Neurotoxin

Tepp

Lin

Johnson

2012

Appl Environ Microbiol

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Botulinum neurotoxins (BoNTs) produced by Clostridium botulinum are of considerable importance due to their being the cause of human and animal botulism, their potential as bioterrorism agents, and their utility as important pharmaceuticals. Type A is prominent due to its high toxicity and long duration of action. Five subtypes of type A BoNT are currently recognized; BoNT/A1, -/A2, and -/A5 have been purified, and their properties have been studied. BoNT/A3 is intriguing because it is not effectively neutralized by polyclonal anti-BoNT/A1 antibodies, and thus, it may potentially replace BoNT/A1 for patients who have become refractive to treatment with BoNT/A1 due to antibody formation or other modes of resistance. Purification of BoNT/A3 has been challenging because of its low levels of production in culture and the need for innovative purification procedures. In this study, modified Mueller-Miller medium was used in place of traditional toxin production medium (TPM) to culture C. botulinum A3 (CDC strain) and boost toxin production. BoNT/A3 titers were at least 10-fold higher than those produced in TPM. A purification method was developed to obtain greater than 95% pure BoNT/A3. The specific toxicity of BoNT/A3 as determined by mouse bioassay was 5.8 ؋ 10 7 50% lethal doses (LD 50 )/mg. Neutralization of BoNT/A3 toxicity by a polyclonal anti-BoNT/A1 antibody was approximately 10-fold less than the neutralization of BoNT/A1 toxicity. In addition, differences in symptoms were observed between mice that were injected with BoNT/A3 and those that were injected with BoNT/A1. These results indicate that BoNT/A3 has novel biochemical and pharmacological properties compared to those of other subtype A toxins.

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confidence: 99%

Purification and Characterization of a Novel Subtype A3 Botulinum Neurotoxin

Tepp

Lin

Johnson

2012

Appl Environ Microbiol

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“…Its central and lateral fibers blend in with the corrugator supercilii and the inner part of the orbicularis oculi. Contraction of the frontalis raises the eyebrows and the upper eyelid, causing the formation of horizontal forehead rhytides 7 . The lower 2.5 to 4.0 cm of the frontalis muscle moves cephalad to elevate the eyebrows 8 , and over time, repeated muscle contraction can result in the formation of rhytides.…”

Section: Discussionmentioning

confidence: 99%

Exaggeration of Wrinkles after Botulinum Toxin Injection for Forehead Horizontal Lines

et al. 2011

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There have been no long-term complications or lifethreatening adverse effects related to botulinum toxin treatment for any cosmetic indications. Nevertheless, there are well-known, mild side effects of botulinum toxin treatment on the upper face, though most of them are self limited with time. However, excluding brow ptosis, reports about site specific side effects are few and anecdotal. We experienced cases of exaggeration of wrinkles after botulinum toxin injection for forehead horizontal lines, and report them here. In our cases, new appearance of a noticeable glabellar protrusion following botulinum toxin injection on the forehead was observed in 2 patients. Also, a new deep wrinkle on one side of the forehead just above the eyebrow appeared in another 2 patients. The exaggerated wrinkles nearly disappeared without treatment by week 4 in all subjects. These exaggerations of wrinkles may be caused by hyperactivity and overcompensation of untreated muscles. With the increasing availability of diverse botulinum toxin for cosmetic purposes, physicians and patients should be aware of this temporary change after therapeutic injections. We recommend explaining this possible effect prior to injection, for better understanding of treatment for cosmetic indications. (Ann Dermatol 23(2) 217∼221, 2011)

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“…The frontalis raises the eyebrows and the upper eyelids, causing horizontal forehead lines. Its medial fibers intersect with the procerus at the glabellar region, whereas its central and lateral fibers intermingle with the corrugators in the central and lateral parts [7] . When the upper half part of the muscle is weakened with botulinum toxin for the improvement of forehead wrinkles, the lower half can be relatively hyperactivated.…”

Section: Receivedmentioning

confidence: 99%

Correction of glabellar protrusion after botulinum toxin injection for forehead wrinkles

et al. 2016

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<p>Botulinum toxin blocks the release of the neurotransmitter acetylcholine and helps to treat wrinkles. The efficacy and safety of botulinum toxin injection for upper facial wrinkles were established in several previous studies. Common side effects include transient headache, bruising, eyebrow ptosis and eyelid swelling. No adverse life threatening events or long-term complications have been reported. However, there have been a few reports on site-specific side effects, except for eyebrow ptosis or eyelid swelling. Two previous cases showing exaggerated glabellar wrinkles after botulinum toxin injection for forehead horizontal lines reported that no specific treatment for the exaggeration of wrinkles were done and it was left to slowly recede. In the present report, we highlighted a patient, whose significant glabellar protrusion was rapidly and effectively corrected with the use of botulinum toxin injection.</p>

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International consensus recommendations on the aesthetic usage of botulinum toxin type A (Speywood Unit) – part I: upper facial wrinkles

Abstract: Background Azzalure (Galderma SA) is a newly approved European botulinum neurotoxin type A (BoNT-A). It is

Cited by 98 publications

References 32 publications

Purification and Characterization of a Novel Subtype A3 Botulinum Neurotoxin

Purification and Characterization of a Novel Subtype A3 Botulinum Neurotoxin

Exaggeration of Wrinkles after Botulinum Toxin Injection for Forehead Horizontal Lines

Correction of glabellar protrusion after botulinum toxin injection for forehead wrinkles

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