Botulinum toxin and hyaluronic acid in Maxillofacial Surgery

Botulinum toxin is obtained from a bacillus called “Clostridium Botulinum”. Specialists use botulinum toxin to produce muscle relaxation, eliminating facial wrinkles.

Botulinum toxin has several applications in aesthetics approved by the Ministry of Health for the frontal region, in the glabellar area, the area between the eyebrows. To remove expression wrinkles that occur over the years.

It also has a clinical use to treat various problems. It began to be used in ophthalmology for the treatment of strabismus and is already used in multiple specialties such as urology for cases of bladder hypertonia, in general medicine and digestive system to treat sphincter problems and is widely used in neurology to treat, above all, problems of muscular dystonia.

In maxillofacial surgery it is used primarily for hyperfunction or dystonia of the masticatory muscles and facial muscles, in problems that can occur in facial paralysis. And it is used for problems of hypersweating in the area where the parotid gland is located, which occurs mainly after surgery to remove the parotid gland, called parotidectomy, which is a very frequent surgery in maxillofacial surgery to treat mainly benign and malignant tumors of the parotid region.

Facial fillers: hyaluronic acid

Fillers are used to increase the volume of an area and thus rejuvenate it. There are several types of fillers, some are biodegradable and others are permanent. Permanent fillers have produced, on many occasions, problems of rejection, infection and granulomas. So personally, we do not recommend their use.

Within the biodegradable ones there are several types, the most widespread is hyaluronic acid. It is a material obtained from bacterial synthesis. And, therefore, it is very safe, gives few adverse reactions – few allergic problems, which are exceptional – and is biodegradable. It lasts, depending on the type, between 6 to 9 months.

Hyaluronic acid is mainly used in the nasolabial area to produce a rejuvenation of this area, which is a key area in the facial aesthetics of the lower third of the face, and solves the problem of flat lips with wrinkles known as bar code. Or the nasolabial folds that with age, due to the process of maxillary reabsorption, are very marked and produce an aged effect on this area.

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In facial aesthetics it is also used to increase and reaffirm the area of the cheekbones or chin. And they are an ideal complement to dental implant treatments, to reaffirm and rejuvenate the tissues of the nasolabial area. In addition to these aesthetic applications, it has indications for reconstructive surgery of the face. When we find sagging, defects or lack of tissue, which may occur after treatment of oncological surgery tumors, after trauma and also syndromes or diseases that produce atrophy of the soft tissues.

The rise of botulinum toxin and hyaluronic acid

Botulinum toxin and hyaluronic acid fillers are the most common procedures in cosmetic surgery. About 2 million botulinum toxin procedures and 1.5 million facial fillers are performed in the U.S. each year. This represents a very large comparative volume in relation to the rest of plastic or aesthetic surgery procedures -perhaps 1.2 million in total, including breast surgery, liposuction, rhinoplasty, lifting…-.

They are very common procedures because they do not require, most of the time and except in reconstructive surgeries, the use of operating rooms. They can be performed in the clinic by specialists with the necessary training, because they do not require sedation or general anesthesia and have a duration of application of 15 to 30 minutes. In fact, the Anglo-Saxons call it “lunch time” because it is done in a short period of time and without inflammatory sequelae.