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Myobloc™
Clostridium botulinum can be safely and painlessly injected directly in a specific muscle to relax that muscle temporarily. This treatment has been used for many years for the treatment of nervous tics and strabismus (lazy eyes). The treatment of frown lines, crow's feet, forehead wrinkles, and the neck folds with BOTOX®™ (botulinum toxin type A) has been used successfully for these facial wrinkles since 1981. Myobloc™ is a different type of botulinum toxin (type B) that is also used to treat facial wrinkles. It was FDA approved for the use of cervical dystonia in December 2000 and has been used for facial wrinkles since that time.
Myobloc™ is administered with a tiny needle. After the injection, the muscle is temporarily relaxed, thus, stopping the ability of the muscle to shorten and allowing the wrinkle lines to gradually disappear. This can help prevent future wrinkling of the skin. Myobloc™ can also help get rid of the angry expression that we get when we wrinkle our brows.. Although Myobloc™ is temporary, it can help train you to not use these muscles as often, therefore, "curing" you of the habit of wrinkling the brow. In most of the patients the effects last several months.
The injections are painless in most of people, and anesthesia is not necessary. If you prefer to use a topical anesthetic, EMLA, arrive 20 minutes prior to your appointment. Bruising can occur but is common around the area of the crow's feet. Use of topical Vitamin K cream to the area 1 prior to the injection can lower the incidence of bruising. Ice packs can be applied after the procedure to decrease the chance of bruising. Use of Vitamin E, green tea, coumadin, ibuprofen (Advil), Motrin, or aspirin will increase the incidence of bruising. It is best to have the injections performed 4 days prior to an important event in case bruising occurs.
Besides bruising, the second most common side effect is dry mouth. This is temporary and usually resolves within a few days or weeks. The most serious side effect of Myobloc™ is ptosis (drooping of the eyelid) which can happen in a small percent of patients. If this happens, it usually resolves in 1 -2 weeks. It is often so subtle that the patient doesn't notice it. To diminish the incidence of developing ptosis, we avoid treating the area of the forehead just over the eyebrow.
Once the Myobloc™ has been injected, it takes 48 - 72 hours for the maximum effects to be apparent. Please drop by our office in 3-4 days so that our staff can make sure that you have achieved the maximum results. This takes approximately 10 minutes and an appointment is not necessary.
After the injections, you can return to work or any social commitment immediately. You should move the muscles as much as possible during the 3 days following the injection so that the Myobloc™ can" discover" the muscles and it will have a stronger effect. You should not lower their head below the level of your heart during 4 hours after the injection. It has been said that this prevents diffusion of the Myobloc™ to other areas. You can wash your face and it can use your home glycolic products and Retin A as usual.
Feel free to call our office if you have any questions.
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