Surgeon Shares Tips for Incorporating Botulinum Toxin into Ophthalmology

January 13, 2024

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Wailea, Hawaii — While very similar, there are some differences in the use of the five available botulinum toxin types, so when first combining those treatments into practice, it's best to start with one, according to one presenter.

Jolie Kaufman, MD, FAAD, He shared his pearls about working with the five botulinum toxins available in the US Focusing on the glabella During his presentation at Hawaii Eye/Retina 2024.

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Although very similar, there are some differences in the use of the five available botulinum toxins, so when first combining those treatments in practice, it's best to start with one, according to one presenter.

The five different botulinum toxins approved in the U.S. to work on glabella all work the same way, by blocking the release of acetylcholine and preventing muscle contraction, Kaufman said. „But they're still a little bit different. How you store them, how you prepare them, how you mix them, they taste different. So if you're going to do that, if you're going to start picking one, you better get used to it.

Joel Kaufman

Joel Kaufman

Kaufman highlighted five common primary glabellar contraction, or frowning, patterns – U, V, Converging Arrows, Vertical Movement or Convergence, Omega, and Reverse Omega Pattern. Characterizing these patterns opens the door to more precise and better targeted and effective treatment with neuromodulators, Kaufman said.

The dose of botulinum toxin should be based on the patient's muscle mass.

„In patients with strong muscles, you may need to dose a little more than the label, and in others you may need to dose less than the label,” he said. „If you do this, you can really increase patient satisfaction and reduce unpleasant side effects.”

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