Botulinum Toxins

Question 1

Clostridium are aerobic gram positive spore forming bacilli

Answer 1

False - anaerobic

Question 2

Botox binds selectively and reversibly to cholinergic nerve terminals, mediated by its heavy chain

Answer 2

False - irreversibly

Question 3

Neuromuscular diseases such as Lambert Eaton syndrome are contraindicated, as are Bell’s palsy and peripheral neuropathy

Answer 3

True

Question 4

What are contraindicated concomitant usage of medications

Answer 4

Quinine , calcium channels blockers, penicillamine , aminoglycosides

Question 5

Botulinumtoxin in glabella causes what changes?

Answer 5

Eyebrow-lifting and reverses physiological ptosis of the eyelids and eyebrows
- by doing that can retard the need for blepharoplasty and brow lifting

Question 6

Which muscle and location targeted for glabellar frown lines ?

Answer 6

PROCERUS 1-2 points of muscle and corrugator 1cm above orbital rim

Question 7

Which muscle and location targeted for periorbital wrinkles

Answer 7

Orbicularis oculi - at level of lateral canthus at a minimum distance of 1cm from the lateral orbital rim . 2 or 3 more additional points may be injected , 1-1.5cm above and below the first marked in a line following the orbital rim

Question 8

Which muscle and location targeted for bunny lines?

Answer 8

Transversal areas of nasal is . Apply injection in the high lateral nasal wall, below the angular vein, avoid injections near the nasofacial groove (to prevent relaxing levator labii superioris muscle causing ptosis)

Question 9

Which muscle and location targeted for nasal flare?

Answer 9

Lower nasal is muscle above the alae nasi

Question 10

Which muscle and location targeted for nasal tip droop?

Answer 10

Depressor septi nasi - inject base of columnella 4U ONA/INCO or 10U ABO

Question 11

Which muscle and location targeted for gummy smile

Answer 11

Levator labii superioris . Inject 0.5-1cm lateral and below ala nasi

Question 12

Which muscle and location targeted for Perioral wrinkles ?

Answer 12

Orbicularis oris —> inject at vermillionectomy border or up to 5mm from border. Low doses of 0.5-1U of ONA/INCO or 1.5-2.5U of ABO

Question 13

Which muscle and location targeted for marionette lines?

Answer 13

Depressor anguli oris , 2U ONA/INCO or 5U ABO in each injection point directly above the mandibular angle, along its rim and 1cm lateral to the oral commisure bilaterally. In an imaginary line following direction of the nasolabial furrow

Question 14

Which muscle and location targeted for dimpled chin

Answer 14

Mentalis muscle. Either one point technique just below the tip or prominence of chin located at the midline or two points bilaterally and symmetrically at the most distal point of the mentalis muscle

Question 15

The starch iodine test is also known as the Minor test

Answer 15

True

Question 16

Botox touch ups can be performed after 10-15 days

Answer 16

False 15-30 days to optimise the results, treat unwanted lines and to correct minor side effects such as asymmetry or excessive brow elevation. Avoid frequent or repeated touch ups