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Biomedical subjects

Jean Carruthers

Publications and source records attributed to Jean Carruthers.

28 records · Page 2Linked to original sources
PubMed2003

Aesthetic botulinum A toxin in the mid and lower face and neck.

BACKGROUND: Botulinum toxin type A (BOTOX formulation) is used extensively for smoothing hyperkinetic lines in the upper face. The use of botulinum toxin for aesthetic indications in the mid and lower face and neck is now becoming increasingly popular. OBJECTIVE: To review our current approaches to botulinum toxin treatment for cosmetic indications in the mid and lower face and neck. METHODS: Procedures and outcomes are described for the primary and adjunctive use of botulinum toxin. RESULTS: Cosmetic treatment with botulinum toxin successfully changes the contour of the palebral aperture; smoothes lines, including "bunny" lines, perioral rhytides, and horizontal neck lines; softens creases, including the mental crease and melomental folds; and alleviates facial asymmetry and nasal flare. The doses of botulinum toxin used in the mid and lower face are generally lower than those used in the upper face. Caution must be used in injecting botulinum toxin in the perioral area to avoid an incompetent mouth. CONCLUSION: Botulinum toxin treatment is valuable for aesthetic improvements in the mid and lower face and neck. In some areas, particularly the perioral region, the use of botulinum toxin in combination with other therapeutic modalities provides optimal results.

Botulinum Toxins, Type A↗
PubMed2003

Deep resting glabellar rhytides respond to BTX-A and Hylan B.

BACKGROUND: BTX-A is the standard treatment for glabellar furrows. However, some individuals have resting glabellar rhytides that are sufficiently deep that they respond poorly to BTX-A alone. OBJECTIVE: To compare the efficacy of BTX-A combined with intradermal Hylan B with the efficacy of BTX-A alone in individuals with moderate to severe glabellar rhytides. METHODS: This was a retrospective study of 16 subjects with moderate to severe glabellar rhytides. Their response to Hylan B plus BTX-A was compared clinically and photographically to their response to BTX-A alone. RESULTS: All subjects had moderate or severe glabellar rhytides at rest before treatment. After BTX-A alone, none (0%) had achieved no or mild rhytides. After BTX-A and Hylan B injection, only 1 of 16 (6%) had moderate glabellar rhytides, with the remainder (94%) being mild. CONCLUSION: Moderate to severe glabellar rhytides were treated better by BTX-A combined with Hylan B injection than by BTX-A alone.

Adult↗
PubMed2003

A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox) and nonanimal sourced hyaluronic acid (NASHA, Restylane) in combination compared with NASHA (Restylane) alone in severe glabellar rhytides in adult female subjects: treatment of severe glabellar rhytides with a hyaluronic acid derivative compared with the derivative and BTX-A.

BACKGROUND: Over the past 15 years, BTX-A has become the standard treatment for dynamic glabellar furrowing. Some individuals have resting glabellar rhytides that are sufficiently deep that they respond poorly to BTX-A alone. OBJECTIVE: To compare the efficacy of BTX-A combined with intradermal nonanimal stabilized hyaluronic acid (NASHA) with the efficacy of NASHA alone in females with moderate to severe glabellar rhytides. METHODS: This was a prospective randomized study of 38 subjects with moderate to severe glabellar rhytides. Half of the subjects were treated with BTX-A and NASHA and the other half with NASHA alone. Their response was assessed clinically and photographically. RESULTS: By comparison with the NASHA-alone group, the BTX-A plus NASHA group showed a better response both at rest and on maximum frown, and this response was maintained for longer. The median time for return to preinjection furrow status occurred at 18 weeks in the NASHA-alone group compared with 32 weeks for the BTX-A plus NASHA group.

Adult↗
PubMed2003

Botulinum toxin A: its expanding role in dermatology and esthetics.

The use of botulinum toxin A in cosmetic dermatology has increased in popularity due to the efficacy and relative safety of the treatment. Botulinum toxin A is one of eight exotoxins produced by Clostridium botulinum, a Gram-positive, spore-forming anaerobe. Flaccid paralysis results from the denervation of muscle fibers at the neuromuscular junction after botulinum toxin A administration. While treating blepharospasm, the Carruthers incidentally found that botulinum toxin A improved glabellar frown lines. Dynamic rhytides occur in areas of dynamic motion. These types of lines may be improved with botulinum toxin A. There are two types of botulinum toxin A commercially available (BOTOX and Dysport); only BOTOX is currently available in the US. The efficacy and tolerability of BOTOX was best demonstrated with a multicenter, double-blind, randomized, placebo-controlled study of the efficacy and safety of botulinum toxin type A in the treatment of glabellar lines in 264 patients. There was a significantly greater reduction in glabellar line severity with BOTOX. The effect was maintained for the duration of the study (120 days). There was low occurrence (5.4%) of mostly mild blepharoptosis in the BOTOX group. In another prospective study, it was found that about 1% of BOTOX patients reported severe headache. Botulinum toxin A can provide an alternative treatment of palmar and axillary hyperhidrosis when options such as topical agents (aluminum chloride) and iontophoresis have failed.

Botulinum Toxins, Type A↗
PubMed2002

HIV-associated facial lipoatrophy.

BACKGROUND: HIV-infected individuals are living long, healthy lives. They are now concerned with less life-threatening problems, especially lipodystrophy. OBJECTIVE: To review the current state of our knowledge about lipodystrophy in HIV-infected individuals. METHODS: The literature was reviewed and analyzed for relevant information. In addition, our clinical experience of managing such individuals was utilized. RESULTS: Lipodystrophy and facial lipoatrophy and their relationship to HIV-infection are discussed. Their differences are noted. The spectrum of appearance in individuals with facial lipoatrophy is described and a severity scale suggested which should be of value in assessing the results of treatment. CONCLUSION: Lipodystrophy and lipoatrophy are intimately related to infection with HIV. In consequence, facial lipoatrophy is a major stigma for HIV-infected individuals and can have dramatic effects on their self-esteem and socialization. Effective treatment is essential.

Antiretroviral Therapy, Highly Active↗
PubMedDate not supplied

Botox: beyond wrinkles.

First used and approved over a decade ago for the treatment of strabismus (or misaligned eyes), botulinum toxin (BTX) has demonstrated efficacy in blepharospasm, hemifacial spasm, spastic lower eyelid entropion, and a number of other disorders seen in the traditional medical environment that are characterized by abnormal muscle contraction. Moreover, other conditions-notably some pain and gastrointestinal disorders-have responded to BTX injections.

Botulinum Toxins↗
PubMedDate not supplied

Combination therapy with BOTOX and fillers: the new rejuvnation paradigm.

Until relatively recently, restoration of appearance by replacement of lost facial volume and muscular relaxation has been an illusory goal. With advances in the commercial availability of newer filling agents and a better understanding of the clinical esthetic effects of botulinum toxin A, remarkably sophisticated and refined results can now be achieved by using these noninvasive techniques. The combined use of BTX-A and filling agents, such as collagen and hyaluronic acid, can restore facial appearance by the dual mechanisms of reflation and relaxation. In addition, their combined use appears to increase the longevity of tissue dwell time of the filling agent. Current practices now strive to correct wrinkles by restoring volume and also relaxing the pull of muscles that create negative facial expressions such as glabellar folds, mouth frown, crow's feet, horizontal forehead lines, and perioral and cervical rhytides. As with any of the new technological innovations currently available, understanding of the differing properties of the agents used and education in optimal technique is essential to clinical and esthetic success.

Botulinum Toxins, Type A↗