Tips and Tricks

■ Focus the treatment of facial asymmetries on the muscle vectors and distribute the botulinum toxin in an even manner. Remember that blocking one single muscle may unbalance the others. When starting to treat facial asymmetries do not try to aim for a single treatment session; be cautious and use at least a two-step treatment with

Adant, JP (1998) Endoscopically assisted suspension in facial palsy. Plast Reconstr Surg 102:178 Arden RL, Sunhat PK (1998) Vertical suture placation of the orbicularis oris muscle: a simple procedure for the correction of unilateral marginal mandibular nerve paralysis. Facial Plast Surg 14:173 Armstrong MW et al. (1996) Treatment of facial synkinesis and facial asymmetry with Botulinum toxin type A following facial nerve palsy. Clin Otolaryngol 21:15 Aviv JE, Urken ML (1992) Management of the paralyzed face with microneurovascular free muscle transfer. Arch Otolaryngol Head Neck Surg 118:909 Badarny S et al. (1998) Botulinum toxin injection effective for post-peripheral facial nerve palsy synkinesis. Harefuah 135:106 Bento RF et al. (1994) Treatment comparison between dexamethasone and placebo for idiopathic palsy. Eur Arch Otolaryngol Dec: S535 Bernardes DFF et al. (2004) Functional profile in patients with facial paralysis treated in a myofunctional approach. Pro Fono 16:151 Bikhazi NB, Maas CS (1997) Refinement in the rehabilitation of the paralyzed face using Botulinum toxin. Otolaryngol Head Neck Surg 117:303 Bleicher JN et al. (1996) A survey of facial paralysis: etiology and incidence. Ear Nose Throat J 75:355-358 Boerner M, Seiff S (1994) Etiology and management of facial palsy. Curr Opin Ophthalmol 5:61

Boroojerdi B et al. (1998) Botulinum toxin treatment of synkinesia and hyperlacrimation after facial palsy. J Neurol Neurosurg Psychiatr 65:111 Brans, JW et al. (1996) Cornea protection in ptosis induced by Botulinum injection. Ned Tijdschr Ge-neeskd. 140:1031 Burres SA, Fisch U (1986) The comparison of facial grading systems. Arch. Otolaryngol. Head Neck Surg


Burres SA (1985) Facial biomechanics: The standards of normal. Laryngoscope 95:708 Burres SA (1986) Objective grading of facial paralysis.

Ann Otol Rhinol Laryngol 95:238 Burres SA (1994) The qualification of synkinesis and facial paralysis. Eur Arch Otolaryngol Dec:S177 Carruthers A, Carruthers J (2001) Botulinum toxin type A: history and current cosmetic use in the upper face. Sem Cut Med Surg 20: 71 Clark RP, Berris CE (1989) Botulinum toxin: a treatment for facial asymmetry caused by facial nerve paralysis. Plast Reconstr Surg 84:353 Dawidjan B (2001) Idiopathic facial paralysis: a review and case study. J Dent Hyg 75:316 Dobie RA, Fisch U (1986) Primary and revision surgery (selective neurectomy) for facial hyperkinesia. Arch Otorhinolaringol Head Neck Surg 112:154 Dodd SL et al. (1998) A comparison of the spread of three formulations of botulinum neurotoxin A as determined by effects on muscle function. Eur J Neurol 5(2):181-6

Dressler D, Schonle PW (1991) Hyperkinesias after hy-poglossofacial nerve anastomosis - treatment with Botulinum toxin. Eur Neurol 31:44 Faria JCM (2002) A critical study of the treatment of facial palsy through a gracilis transfer. Doctoral thesis, Medical College, University of the State of Sao Paolo. Farkas LG (1997) Anthropometry of the head and face.

Second edition. New York: Raven Press pp 545-57 Fine NA et al. (1995) Use of the innervated platysma flap in facial reanimation. Ann Plast Surg 34:326 Guereissi JO (1991) Selective myectomy for postparetic facial synkinesis. Plast Reconstr Surg 87:459 Harii K et al. (1998) One-stage transfer of the latissiumus dorsi muscle for reanimation of a paralyzed face: a new alternative. Plast Reconstr Surg 102:941

lower doses to minimize complications.

5 Common Skin Problems Answered

5 Common Skin Problems Answered

Our skin may just feel like a mere shield that protects us from the world outside. But, the fact is, its more than just the mask that keeps your insides in. It is a very unique and remarkable complex organ that reflects our general health.

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