By Goldman M.P., Sadick N.S., Weiss R.A.

Compiled by means of professional specialists within the box, this reference presents transparent tips at the simple ideas, systems, and problems concerned with complex dermatologic surgery-offering particular insurance of filling elements, fats move suggestions, and the most recent laser applied sciences.

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Lowe et al. (37) compared the safety and efficacy of ablative laser resurfacing combined with BTX-A, with that of a placebo for the treatment of crow’s feet. BTX-A in conjunction with ablative resurfacing resulted in significantly higher treatment success rates compared with laser alone. 34 Carruthers and Carruthers COMPLICATIONS The complications associated with the aesthetic use of BTX-A are few and anecdotal, and there have been no reported long-term adverse effects or health hazards following its use for any cosmetic indication (38).

Ecchymoses can be reduced by injecting superficially in a Figure 4 (A) shows an individual with mild, left-sided eyelid ptosis following BTX injection. 5% apraclonidine were applied to the left eye. 36 Carruthers and Carruthers wheal or a series of continuous blebs, avoiding blood vessels by placing each injection at the advancing border of the previous injection. Injecting the infraorbital orbicularis can produce significant benefit in younger individuals, but the reverse may occasionally be true, especially in older individuals.

Thirty minutes after removal, Betacaine-LAÕ was found to have significantly better effect than the control (Fig. 3) (20). EMLA and LMXÕ were statistically superior to Betacaine-LAÕ at both time intervals. More clinical trials are needed to determine the comparative efficacy, safety profile, and the role of occlusion. TETRACAINEÕ Amethocaine 4% gel which contains 4% TetracaineÕ is marketed in Europe as providing more rapid and perhaps a longer duration of cutaneous anesthesia than EMLA. In a double-blind study of 29 patients using 4% amethocaine and EMLA for one hour prior to pulsed-dye laser treatment of port wine stains, amethocaine was significantly better than EMLA by visual analogue and verbal rating scores in reducing pain caused by the laser treatment (52).

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