Surgeon shares tips for incorporating botulinum toxins into ophthalmic practice
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WAILEA, Hawaii — While being very similar there are some differences in using the five available botulinum toxins, so when first incorporating those treatments into practice it is best to start with just one, according to a presenter here.
Joely Kaufman, MD, FAAD, shared her pearls for working with the five available botulinum toxins in the U.S. focusing on the glabella during her presentation at Hawaiian Eye/Retina 2024.
The five different botulinum toxins approved in the U.S. for working on the glabella all work the same way, by preventing acetylcholine release and preventing muscle contraction, Kaufmann said. “But they still are all a little bit different. They have a different flavor as far as how you store them, how you prepare them, how you mix them. So, if you’re going to do it, and you’re just starting maybe pick one, so you get used to it.”
Kaufman highlighted five common primary glabellar contraction, or frown, patterns — the U, the V, the converging arrows, the vertical movement or converging, the omega and the inverted omega pattern. Classifying these patterns opens the door for more precise and better targeted and effective treatment with neuromodulators, Kaufman said.
Dosing for botulinum toxins should be based according to the patient’s muscle mass.
“In patients with strong muscles, you're going to need to dose a little higher than on-label, while in others you may need to dose lower than on-label,” she said. “If you do it this way, you can really increase patient satisfaction and decrease undesirable side effects.”
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Kaufman J. Botulinum toxins: What, when, where. Presented at: Hawaiian Eye/Retina 2024; Jan. 13-19, 2024; Wailea, Hawaii.
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