I have read that Dysport may interfere with facial muscles. Does injection for wrinkles in the corner of the mouth and forehead pose a complication? http://www.bcm.edu/dermatology/?PMID=1909
Dysport's Effect on Facial Expression?
Doctor Answers 8
Dysport, Botox neuromodulators
Botox, Dysport and Xeomin are neuromodulators, meaning they alter the function of the muscle they are injected into. The very mechanism of action of Botox is to "interfere" and inhibit the contraction of facial muscles. However, they are injected in a way to selectively interfere with muscles, so that the very muscle movements that cause unwanted wrinkles are eliminated, but the normal movements that result in facial expressions are preserved. When performed conservatively, the average observer will not be able to tell you have had anything done.
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Dysport's effect on facial expression
Dysport is used to relax unwanted muscle movement. It is important to have treatment with an experienced injector who can assess your movement and treat accordingly to give you a natural-looking result. Treatment around the mouth and forehead is commonly performed.
Dysport's Effect on Facial Expression
Thank you for your question. Be certain to be under the supervision of a board certified dermatologist or plastic surgeon with expertise in injectables for the safest and most effective treatments. Dysport is injected locally into the muscle to soften lines and may be injected in the corner of the mouth and forehead. There are also side effects that can occur such as drooping of the lids, brows or lips, etc. so placement of Dysport is very important. I hope this helps.
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Facial expressions following injections
If you don't want your facial expressions to change at all, you should definitely not get dysport. That is what these medications do; they paralyze your frontalis muscle and glabella muscle to give you a more youthful look.
Dysport does effect facial expression
Dysport, as well as the other Botulinum Toxin Type A products, is intended to effect facial musculature. Ideally we would like it to effect only certain muscles or muscle groups that create certain facial expressions like scowling or squinting while leaving things like your smile uneffected. Misplacement of Dypsort in the forehead, or other toxins, can result in not only altered brow movement an altered shape to the eyebrows and possibly even a drooping eyelid. Injections near the mouth or chin can be helpful for the vertical lip lines and helping with dimpling in the chin but can also effect the smile. It is important to chose an injector that has had a good deal of experience injecting to give you the results you want while minimizing the chance of side effects.
Dysport stops muscle movement
Dysport, Botox, and Xeomin all work by temporarily disrupting the communication between nerves and muscles. Muscles will not receive the message to contract, and won't move. When injected in the glabella and forehead, the eyebrows won't raise or knit together. When injected in the crow's feet area, wrinkles around the eyes smooth out. Injections around the mouth can be used to smooth perioral wrinkles, but must be done so with caution, because movement around the mouth is important for chewing, making sounds, and expressions. Too much Dysport or incorrect placement can cause asymmetry, drooping of the mouth, or problems with chewing. Of note, all neurotoxins are only approved for the cosmetic use of smoothing glabellar lines; all other locations are off-label. If considering the treatment, be sure to have a board certified dermatologist or plastic surgeon with cosmetic experience perform it.
How neurotoxins such as Dysport work
Neurotoxin injections such as Dysport, Botox and Xeomin reduce wrinkles by the temporary and reversible paralysis of treated muscles. Many wrinkles are caused by contractions of facial muscles under the skin. Prior to treatment with neurotoxin injections, physicians must evaluate the patient to analyzing their facial anatomy. A clear understanding of the relationship between depressor and elevator muscles and muscle mass is necessary for the proper use of neurotoxin injections. Depressor muscles tend to draw the face down and play an important role in the aging process. Weakening of depressor muscles with neurotoxins will lessen their depressive effects. Elevators tend to lift the face, so that with the depressor muscles weakened, the elevator muscles may strengthen with time.
Treating the Forehead and Corners of the Mouth with a Botulinum Toxin type A
Botox, Dysport, and Xeomin are supposed to interfere with facial muscle activity. All work by inhibiting the release of the neurotransmitter, acetylcholine, across the neuromuscular junction. In other words, they prevent the release of the chemical signal from the nerve ending that stimulates the muscle to contract. When that chemical (acetylcholine) is reduced, or blocked completely, the muscle relaxes. The result is weakness or paralysis of the muscle, depending upon the amount of botulinum toxin present.
Botox, Dysport, and Xeomin are all serotype A botulinum neurotoxins (BoNT-A). As a result they have very similar activity and characteristics, and are more similar than they are different; the actual “toxin” molecule in each is essentially identical.
If these products are administered in larger doses, or placement of the product is incorrect, weakness or paralysis may occur in nearby muscles which were not intended to be treated. For this reason it is important that you seek and experienced injector.
Treatment for lines of the forehead and the corners of the mouth are considered “off -label”, since these products are FDA approved for treatment of moderate to severe frown lines of the glabella. Transverse forehead lines are treated by injecting the frontalis muscles within the forehead. Down-turned (lines) corners of the mouth can be improved by injecting the depressor anguli oris (DAO) muscles; this muscle is treated at some distance from the corner of the mouth.
Unsatisfactory results can occur following treatment of either forehead lines or down-turned corners of the mouth. The most common complication following treatment of forehead lines is brow ptosis; the eyebrows droop and patients often feel a heavy brow or heaviness in their upper eyelids. The most common complication following treatment of the DAO is weakness of adjacent muscles or some asymmetry in movement of the mouth. An experienced BoNT-A injector will know the pertinent facial anatomy of these areas, as well as the proper dosing range, both of which are important in avoiding unexpected outcomes.
Drooping corners of the mouth can also be improved by using a soft tissue filler. The best elevation of the corners of the mouth may result from combination therapy utilizing a filler and BoNT-A.
Best wishes, Ken Dembny
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.