- History of the creation and use of botulinum toxin
- History of the use of botulinum toxin in aesthetic medicine
- Botulinum toxin preparations: Botox, Dysport, Lantox
- Mechanism of action and use of botulinum toxin
- Indications and contraindications for the use of Botox, Dysport, Lantox
- The procedure for administering Botox, Dysport, Lantox
- Side effects and complications of drugs Botox, Dysport, Lantox
- Removal of facial wrinkles using Botox, Dysport, Lantox
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Facial symmetry is a key factor in determining facial attractiveness. Preference for symmetrical faces appears to be innate, as it appears even in newborns. This preference for symmetry is common in most cultures and likely evolved as a mechanism for selecting an ideal mate. Over the years of successful use of botulinum toxin preparations - such as Botox, Dysport, Lantox, this type of therapy has developed from a method of combating wrinkles into a technique for changing the shape of the face. By understanding the actions of the various facial muscles, facial structures can be more reliably corrected and reshaped, thereby improving facial symmetry.
Types of facial symmetry disorders
The symmetry of the face depends on the structure, volume:
- muscles;
- fatty tissue;
- nerves and blood vessels;
- joints, skull bones;
- cartilage and connective tissue;
- ligaments
The cause of asymmetry can be individual anatomical and morphological structural features (physiological disproportion) or pathological (diseases, injuries) and a combination of these factors.
In addition, asymmetry of the facial part of the skull is divided into:
- morphological (static) – deformation is caused by a violation of the location, shape, volume of individual elements of bone and soft tissue, noticeable at rest;
- functional (facial) - caused by a violation of the coordination of the work of individual facial muscles or damage to the facial nerve, the anomaly intensifies during facial movements.
Severe facial asymmetry, the causes of which are varied, requires professional treatment.
Eye asymmetry
Asymmetry of the palpebral fissures is quite common. Botox, Dysport, Lantox can be used to correct the “big eye versus small eye” symptom. Symmetry can be achieved by injecting small doses of botulinum toxin. As usual, to enlarge the palpebral fissure, botulinum toxin is injected at the level of the midpupillary line and into the lower part of the orbicularis oculi muscle at a distance of 1 mm from the ciliary edge.
Causes of facial asymmetry
Disproportion of the articular bones of the skull can be congenital or acquired. Congenital anomalies may occur:
- in the prenatal period due to intoxication, infectious diseases suffered by the mother, abnormal position of the fetus, multiple pregnancies, delayed development of individual parts or tissues;
- genetic aberrations.
The consequences of birth defects are:
- disruption of the development of joints and bones of the skull, facial muscles, connective tissue;
- underdevelopment of the lower jaw;
- torticollis;
- strabismus;
- violation of the formation of the temporomandibular joint.
Genetic pathologies accompanied by disproportion of traits include the following microdeletion syndromes:
- monosomy 1p36;
- Wolf-Hirschhorn;
- Sotos;
- Setre-Chotzena;
The deformity can be a consequence of obstetric complications or birth trauma. An example is the famous actor Sylvester Stallone. Damage to the facial nerve led to speech defects and noticeable deformation of the left half of the face.
Rice. 2 Severe asymmetry due to neuritis of the facial nerve
Acquired pathology occurs as a result of:
- tumors in bone tissue - osteomas, osteochondromas, the tumor is localized in the nose, frontal and ethmoid cavities, in the joints and bones of the lower jaw;
- infectious and inflammatory diseases of the ENT organs;
- deviated nasal septum, polyps and cysts;
- trauma and inflammation of the maxillofacial apparatus;
- disruption of the formation or loss of individual units of the dentition, malocclusion;
- pathology of the muscular frame of the face - facial and chewing muscles;
- Cheiloschisis - cleft palate and lip.
A common cause of disproportion of the facial part of the skull is neuropathies:
- Bell's palsy;
- muscle contracture after surgery and paralysis;
- muscle synkinesis;
- unilateral myasthenia;
- injuries and iatrogenic lesions of the facial nerve;
- pain in certain areas of the face;
- dyskinesia and spasm of facial muscles.
Facial asymmetry, neurology considers it from the perspective of a violation of muscle innervation, can be caused by a disease of unknown etiology. Romberg's hemiatrophy leads to multiple facial anomalies, which are caused by degenerative processes, impaired nerve function, and pathology in the opposite hemisphere of the brain.
The causes of the anomaly are also:
- traumatic brain injuries;
- cerebrovascular accident;
- spinal injuries or diseases;
- strabismus and other ophthalmological diseases;
- tissue damage due to violation of the technique of performing cosmetic procedures and surgical interventions;
soft tissue neoplasms.
Figure 3. Deformation caused by crossbite
The deformity can also be caused by a disruption in communication between the hemispheres of the brain. Facial asymmetry, the causes of which are diverse, requires correction, as it leads to complications.
Indications for plastic surgery for the eyes
An eternally tired look, folds on the eyelids and “bags” under the eyes can appear at a fairly young age and the reason for this is chronic illnesses, stress, and skin characteristics. Such defects cause severe discomfort because they cannot be corrected by therapeutic masks, anti-aging creams, or special massages. Changes in the eye area are noticeable to others, so people suffer from psychological discomfort and are looking for effective ways to solve this aesthetic problem.
Due to the fact that modern society reveres the cult of beauty, the popularity of cosmetic surgeries is growing every year. Cosmetic eye surgery has even become a separate field from plastic surgery, but such operations can still be called plastic.
When is cosmetic surgery really necessary?
- large “bags” under the eyes that disrupt the contour of the lower eyelid;
- thinning of the skin and age-related drooping of the tissues of the upper eyelids, interfering with vision;
- drooping upper eyelid - ptosis can lead to decreased visual acuity;
- asymmetry of the eyes due to injury to the eyelids.
Increasingly, people with Asian eye shape are having eyelid surgery to make them look like European eyes. Since many Asians do not have an upper eyelid fold, the surgeon needs to create one during the operation. This type of surgery is extremely popular in East and Southeast Asia.
Diagnostics and examination
To confirm the primary diagnosis and establish the cause of the lesion, it is necessary to conduct visual and hardware diagnostics. The doctor measures axial and angular distances, performs tests at rest and in motion, takes a medical history, and interviews the patient. Hardware diagnostics include:
- radiography;
- MRI;
- electroneuromyography.
Radiography is used for anomalies in the symmetry of the head bones and damage to the sutures of the skull. MRI or CT is used to diagnose soft tissues and brain structures. Muscle tone and strength of the facial nerve are examined using electroneuromyography. Facial parameters are measured using a special device.
If infectious tissue damage or neuroinfection is suspected, laboratory tests are prescribed.
Diagnosis must be comprehensive, since the causes of the lesion can be different. If a patient has severe facial asymmetry, then to establish an accurate diagnosis, consultation with doctors of different specialties may be necessary - a neurologist, an ophthalmologist, an ENT doctor, a neurosurgeon, a psychiatrist, a dentist. They also carry out diagnostics using their own methods. The diagnosis is established after all studies.
Depending on the severity of facial asymmetry, surgery or conservative treatment is prescribed after a joint discussion by a commission of specialists.
Correcting lip asymmetry with permanent makeup
Lip disproportions occur in almost every second woman. Everyone's shortcomings manifest themselves differently. This may be an asymmetrical line of the mouth, unequal corners, uneven thickness of the edges.
There are many reasons for lip asymmetry, but the most common include:
- malocclusion;
- congenital anomalies;
- damaged facial nerve;
- age-related skin changes;
- lack of teeth;
- surgical operations in this area;
- injuries, damage;
- taking medications;
- improper functioning of the facial muscles, their hyperfunction.
Severe lip asymmetry also occurs after lip augmentation with fillers or as a result of poor-quality permanent makeup procedures. The cosmetologist's mistakes cause a pronounced difference between the upper and lower lips, right and left halves.
With the help of lip tattooing, asymmetry of different nature and severity is corrected. To do this, the master selects the appropriate technique: contour with shading, watercolor technique, dense filling or volumetric tattooing. Natural permanent gently eliminates imperfections, creates a natural effect, evens out color, makes features proportional and aesthetically correct. The result lasts for a year, after which it is necessary to update the color using the refresh procedure.
An example of the work of our studio’s specialists in correcting natural lip asymmetry in the before and after photo:
This is what the result of our specialists’ work to correct lip asymmetry, which appeared after poor-quality tattooing, looks like:
Facial asymmetry in adults - how to treat
Treatment depends on the causes of the disease and the severity of the changes. When a diagnosis of facial asymmetry is made, one or more doctors decide how to correct the anomaly. For mild asymmetry, conservative correction methods are sufficient:
- An asymmetrical bite is corrected using splinting, braces and other orthodontic aids.
- When muscles are damaged, drug therapy, physiotherapy, and massage are used. With reduced muscle tone, myostimulation and gymnastics are necessary. Massage relaxes/tones muscles, eliminates pain.
- For neuritis of the facial nerve, treatment is carried out in a hospital. The doctor prescribes medication and physiotherapeutic treatment.
Surgery is required when the structure and function of the jaw joint changes.
Craniosacral manual therapy and massage help correct the asymmetrical skull in children and alleviate the condition of adult patients. In case of significant defects in the articular bones, the neurosurgeon prescribes prosthetic surgery.
At the Clinic of Manual Medicine “Galia Ignatieva MD”, correction of soft tissue lesions is performed using cosmetic minimally invasive methods:
- Botox injections;
- thread lifting;
- hardware massage;
- lipofilling;
- injection of fillers.
Rice. 4. The result of conservative treatment - before and after.
If the asymmetry is severe and does not respond to conservative treatment methods, then a surgical solution to the problem is indicated. It could be plastic surgery.
If there is an abnormal development of the joint of the jaw bones, maxillofacial surgery is prescribed. The neurosurgeon performs surgical treatment of complications of innervation and pathology of the facial nerve.
Facial asymmetry, the treatment of which may require a whole range of measures, is difficult to eliminate if the patient consults a doctor late. Early diagnosis, the professionalism of the doctors at the Manual Medicine Clinic “Galia Ignatieva MD” and compliance with their recommendations in half the cases lead to an improvement in the condition.
Mouth asymmetry
There are numerous muscles in the mouth area that work in different directions. Flattening of the left nasolabial fold at rest indicates hypofunction of the levator muscles: the levator labii superioris muscle, the levator anguli oris muscle, the zygomatic major and minor muscles. A drooping corner of the mouth indicates relative hyperfunction of the muscle that depresses the lower lip and the corner of the mouth. The injection of Botox, Dysport, Lantox into the muscle depressing the lower lip and the angle of the mouth leads to symmetry of the mouth.
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Correcting eyebrow asymmetry
Eyebrow defects manifest themselves in different ways: unequal height, width or length, non-identical bend. Most often, the reason is a natural lack of symmetry, since almost all women have different eyebrows. Sometimes a defect occurs as a result of improper correction, injury, pinching of the facial nerve, age-related changes, or illness.
Often the cause of imbalances is unprofessional permanent makeup, after which a visible defect appears. Read about the features of covering low-quality tattoos in our separate article.
Slight asymmetry can be changed for the better with tweezers and cosmetics, and more severe eyebrow asymmetry can be removed by tattooing. Modern techniques help create eyebrows of the correct shape, which are indistinguishable from natural ones. Depending on the features of the face, the masters of our studio use the hair method, shading, a combined approach, powder spraying or shoting. The period of wearing a permanent is individual, but on average it is about 5 years.
The result of the work of our masters in the before and after photographs:
