BOTOX皮肤美容应用北医PPT课件.ppt

* Botox works best in younger female patients (20 ?45 years of age). In some older patients and in some male patients redundant skin can be created under the brow (), so such patients should be approached with caution. However, treatment of the brow depressors may be necessary after brow ptosis has become manifest. Another complication can be the resulting lack of expressivity that can be caused by injection of frontalis lateral to the midpupillary line. It is important to remember that the brow shape can be changed because you are relaxing the major muscle responsible for elevating the brow. Injections in the forehead should always be above the lowest fold produced when the subject is asked to elevate their forehead (frontalis). If the patient has a low eyebrow, treatment of the forehead lines should be avoided, or limited to that portion of the forehead 4.0 cm or more above the brow. The lower 2.5 to 4.0 cm of the frontalis muscle moves cephalad to elevate the eyebrows. Older people use this to raise their eyebrows to see. Thus, one must always cautiously address the lower frontalis and stay 2 cm above the brow in all individuals. Try never to inject the glabella and the entire forehead during the same session. This will invariably produce brow ptosis. 照片 * 并发症 瘀斑——冰敷 复视 下睑皮肤进一步松弛 睑外翻 笑容不对称 部分静态纹不能完全消失 * 注射技巧 直接注射在肌肉上, 不要在皮内. 注射太表浅, 会让药物较多扩散, 导致作用于肌肉的效果较差. 注射位置准确=治疗效果好+维持时间较长 注射位置应该高于颧骨上缘. * 上半面部多个部位同时治疗 * 同时注射时皱眉纹和鱼尾纹剂量和平时相同 而抬头纹则要用比平时低的剂量 常规手法 * * * * * . * Alastair Carruthers Jean Carruthers University of British Columbia Canada * * * * * * 突触小体相关蛋白（SNAP-25）， 完整的SNARE複合體，是由synaptobrevin(囊膜連結蛋白質)，SNAP -25(胞突結合蛋白質)，以及syntaxin(膜蛋白) 組成 它是蛋白质形成的三部组成的复合体VAMP、Syntaxin和SNAP-25 (SyNaptosomal伴生的蛋白质)。 这复合体在相接，这些神经传送体被填装的泡过程中熔化和胞裂外排干预。 * For crow’s feet we are focusing on the orbicularis oculi muscle only. * * 可以减缓注射时皮肤的敏感度, 但在推入药品时, 仍会有轻微痛感 恩纳麻醉(eutectic mixture of local anaesthetics，EMLA)软膏，瑞典阿斯特拉(ASTRA)药厂生产，主要成分为利多卡因和丙胺卡因两种局麻药，二者按一定比例配备形成乳化的稳定混合剂。 4%脂质体利多卡因(ELA-M