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Publications 1 - Garsing Wong et al.
With the introduction of this new feature we would like to inform our readers about actual injection-lipolysis publications....
Title: Phosphatidylcholine/deoxycholate lipolysis and hyaluronic acid augmentation to enhance nonsurgical lower facial contouring using botulinum toxin type A
Authors: Wong GR, Chen W-P, Auckland/New Zealand
Journal: I. Cosmet. Dermatol. 2011; 10: 159-62
Effective use of selective lower jowl phosphatidylcholine/deoxycholate (PCD) lipolysis and chin, cheek, and nose augmentation with hyaluronic acid (HA) to refine cosmetic lower facial contouring using botulinum toxin type A (BTX-A) in a young Asian woman.
Material and Methods
A 20-year-old Asian woman presented with benign masseteric hypertrophy and a prominent rounded lower face. Combination treatment administered in 11 sessions over a 26-month period included BTX-A 252 U, PCD 3155.5 mg (PC 50 mg/ml, DC 42 mg/ml), and cross-linked HA 38.4 mg injected into the chin and cheeks, and stabilized HA 20 mg injected into the nose.
For lipolysis, topical anaesthetic (benzocaine 9%, lidocaine 9%, and tetracaine 9%) was applied for 20 min. PCD was drawn up in a 3 ml syringe and injected using a 30-gauge half-inch needle 5 mm from the drawn boundary, 1.5 cm apart, in amounts of either 0.25 or 0.5 ml. PCD was injected 10 weeks, 5 months, 9 months and 22.5 months after beginning of treatment with BTX-A.
The combination treatment described very effectively achieved the patient’s desired face shape, and the injection-based procedures were preferable to surgery from the perspective of both the patient and her family.
PCD produced significant swelling, erythema, and tenderness in the affected region in all patients, which lasts from 4 to 14 days. Bruising at the injection site was common.
The authors used PCD lipolysis to effectively enhance nonsurgical lower facial shaping with BTX-A in 29 patients with plump faces or cheeks that lack jowl line definition, with or without masseteric hypertrophy.
In the described combination, BTX-A plays the major role in facial shaping. However, BTX-A cannot produce a slimmer appearance in the lower face in patients with fat in the lower jowl region. This is achieved in these patients with PCD lipolysis.
According to the authors experience, similar outcomes can be achieved with fewer visits by combining the administration of BTX-A with the PCD treatment on the same day.
The PCD dose is determined based on the amount of fat and the desired contouring with injections of undiluted PCD 50 mg/ml. The authors do not inject medially of the marionette line, to avoid blood vessels and nerves in that area, or in the chin.
Ice packs were applied immediately for 20 min duration to reduce swelling and discomfort.
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