14 Questions
What is the technique used to treat contracted muscular bands?
Series of superficial/intradermal injections
What is a common issue in East Asians that can be treated with BTX injections?
Bulky masseter
What is the correct injection site for treating lipstick lines or smoker's wrinkles?
5mm away from the vermilion border
What is a side effect that should be discussed with the patient prior to BTX administration for lipstick lines or smoker's wrinkles?
Dysarthria or oral incompetence
What is a 'gummy smile' characterized by?
Disproportion between gum to tooth ratio
What is NOT corrected by Platysma band injections?
Skin laxity and fat deposits
What is the aim of treating Marionette Lines?
To reduce the strength of the Depressor Anguli Oris muscle
What causes the 'cobblestone' appearance of the skin?
Contraction of the Mentalis muscle
What is the goal of treating Dimpled Chin?
To reduce the chin dimpling
What is the result of contraction of the Platysma muscle?
Platysmas bands
What is the treatment goal for Platysmas bands?
To reduce vertical bands
What should be avoided when treating Marionette Lines?
Injecting too high, which can affect the Orbicularis Oris
What is the precaution when treating Dimpled Chin?
Avoid injecting into the Depressor Labii, which can cause the lower lip to depress
What is the location of the injection point for treating Marionette Lines?
Into the posterior aspect of each DAO
Study Notes
Botox and Filler Clinical Applications
Treatment of Lower Face
- Marionette Lines: contraction of depressor anguli oris (DAO) muscle causes deep lines, giving an unhappy impression
- Treatment: inject 1 cm lateral to mouth corner to reduce DAO strength and lift mouth corners
- Avoid injecting into depressor labii inferioris
Dimpled Chin (Peau D'orange)
- Caused by contraction of mentalis muscle, resulting in "cobblestone" skin appearance and deepening of mento labial crease
- Treatment: 1 central or 2 lateral injections, at least 1 cm from lower lip, to reduce chin dimpling
- Avoid injecting too high, which can affect orbicularis oris and cause lower lip incompetence
Platysmas Bands
- Occur due to relaxation of midline platysma muscle and loss of submental fat, causing "turkey neck" appearance
- Treatment: superficial/intradermal injections directly into contracted muscular band, avoiding dysphagia, dysphonia, and neck weakness
- Note: Platysma band injections will not correct skin laxity and fat deposits, requiring surgical procedures
Masseter Reduction
- Bulky masseter muscle squares the face, common in East Asians
- Treatment: 3-5 injections centered on maximum bulk, assessed by palpation or clenching (lower half), deep and below a line drawn from tragus to angle of the mouth, 1 cm from muscle borders
Smoker's Wrinkles (Lipstick Lines)
- Caused by hypertrophic orbicularis oris, worsened by age, sun exposure, and smoking
- Treatment: BTX for mild wrinkles, BTX with fillers for moderate wrinkles, injecting 5mm away from vermilion border
Gummy Smile
- Characterized by exposure of a larger than average amount of gum tissue, disproportional to tooth size
- Causes feelings of unattractiveness in many people
This lecture covers the clinical applications of botox and filler in oral and maxillofacial surgery, including treatment of lower face issues, marionette lines, and other facial aesthetics. The lecture is part of a second-year oral surgery course.
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