Baltimore Dysport doctors
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Samir Shureih, MD
Baltimore Plastic Surgeon
10 East 31 Street, Baltimore |
35 answers | |
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Ronald Schuster, MD
Baltimore Plastic Surgeon
10807 Falls Rd. Suite 101, Baltimore |
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6 answers |
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Thomas T. Le, MD
Baltimore Facial Plastic Surgeon
4785 Dorsey Hall Drive Suite 111, Ellicott City |
4 answers | |
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Randolph Capone, MD
Baltimore Facial Plastic Surgeon
6535 North Charles Street Suite 250, Baltimore |
2 answers | |
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Robert A. Weiss, MD
Baltimore Dermatologic Surgeon
54 Scott Adam Rd Suite 301, Hunt Valley |
2 answers |
Recent Answers
Had dysport for crows feet 27 wks ago. Included injections towards the middle under my eye. Overnight a bulge under left eye developed which Dr thought was swelling from injection. It did not resolve & I now know it is a herniated orbital fat pad. As muscle activity has returned I have noted that when I smile widely the fat pad is pulled back into place. However when my face is relaxed or smiling slightly the bulge remains. Is it the muscles or septum that support the fat pad in a relaxed face?
Injection in the middle of the orbicularis muscle of the lower lid can cause some fibers of the muscle to become inactive while others are active causing dysharmony with animation (smiling)
Injury to the orbital septum resulting in herniated orbital fat is possible that the needle ounctures the orbital septum , it would be unusual but that depend how experienced the injector is.
Once you are fully sure that the effect of Dysport is completely gone, you will need a full evaluation by a Board Certified Plastic Surgeon (American Board Of Plastic Surgery) and also an opthalmology examination. If it is herniated fat it will need surgery, either redistribution of fat or fat removal.
Do certain areas of the face respond better to Dysport because of differences in the concentration of Dysport compared to Botox?
The two formulations of botulinum toxin available on the market are
1: Botox (onabotulinumtoxin A) made by Allergan
2: Dysport (abobotulinumtoxin A) made by Medicis
These two forms of botulinum toxin have the same effect on the neuromuscular junction. Both drugs inhibit the nerve from secreting acetylcholine. This will render the muscle is unable to contract.
Botox and Dysport have their own specific characteristics. The molecular make up totally different. Each drug molecule has a specific number of proteins that surround the molecule. Botox has more proteins surrounding the molecule than Dysport. This makes Botox a heavier molecule than Dysport. The number of proteins around the molecule and the weight makes these two drugs have different rate of diffusion. Botox diffuse very little, while Dysport will diffuse more. Therefore how much of the drug is injected and where the drug is injected differ. Understanding this phenomenon is very important for a good result and less complications.
In general rough estimate of the dose of Dysport is 2.5 times the Botox dose. But the reality is that one need to titrate the dose of Dysport for each patient. That is why some people experience different results with Dysport than those they experienced with Botox.
Because Dysport diffuses more, it may need to be injected at a higher point than Botox injection site to prevent the migration of Dysport to the upper lid which results in drooping of the eye lid.
Compared to other areas of the face, are there less concerns with Dysport injections in the forehead? Why is the risk lower for complications?
The risks for Dysport are the same as for Botox namely bruising, headache, soreness, malaise and flu-like feeling. More than these though are the undesirable effects of Botulinum Toxin if it spreads to areas not intended, like the upper eyelid muscles, which causes drooping, also known as ptosis. This is fortunately very uncommon among experienced injectors. The main issue about injecting the forehead is determining the effect the treatment will have on the position and thus the appearance of the eyebrows. Patients think that if you inject the forehead it will cause a browlift. It actually is almost the opposite. Treating the forehead can cause the brows to drop since this is the main muscle that actually lifts the brow. it is important to have your injector examine you well for signs that might show that your brows will drop more than you want, or give you an odd "Spockish" appearance. Hope this helps.
