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Neurotoxins and Fillers in Facial Esthetic Surgery

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Chapter 1 Facial Anatomy and Patient Evaluation 1.1 Facial Anatomy 1.2 Anatomy of Facial Skin 1.3 Anatomy of the Superficial Fat Compartments 1.4 Anatomy of the Facial Fasciae 1.5 Anatomy of the Facial Mimetic Muscles 1.6 Anatomy of the Deep Facial Fat Compartments 1.7 Anatomy of the Ligamentous Structures (Retaining Ligaments) of the Face 1.8 The Blood Supply of the Face 1.9 The Aging Face 1.10 Patient Selection, Assessment, Records 1.11 Patient Selection and Assessment 1.12 Treatment SequencingReferences Chapter 2 Neurotoxins: The Cosmetic Use of Botulinum Toxin A 2.1 Botulinum Neurotoxins Introduction 2.2 Botulinum Toxins Physiology and Characteristics 2.3 Manufacturing Process 2.4 Clinical Usage 2.4.1 Age of Patient Treated 2.4.2 Storage and Preparation of BoNTA 2.4.3 Patient Preparation and General Injection Tips 2.4.4 Treatment Recommendations for Specific Areas 2.4.4.1 Glabella 2.4.4.2 Forehead 2.4.4.3 Crow's Feet - Lateral Orbital Lines 2.4.4.4 Indirect Browlift 2.4.4.5 Correcting Brow Asymmetry 2.4.4.6 Other Midface Techniques: Bunny Lines2.4.4.7 Perioral Modifications with BoNTA 2.4.4.8 Treatment of Platysmal Bands 2.5 Treating Facial Asymmetries Secondary to Muscle Paralysis 2.6 Post-treatment Recommendations and Complications 2.7 Conclusion References Chapter 3 Cosmetic Fillers 3.1 History of Cosmetic Fillers 3.1.1 Emergence of Autologous Fillers 3.1.2 Emergence of Non‐autologous Fillers 3.1.2.1 Silicones 3.1.2.2 Bovine Collagen 3.1.2.3 Porcine Collagen 3.1.2.4 Polymethylmethacrylate (PMMA) 3.1.2.5 Hyaluronic Acid 3.1.2.6 Dextran Beads in Hyaluronic Acid 3.1.2.7 Poly-l-lactic Acid3.1.2.8 Calcium Hydroxylapatite 3.1.2.9 Polyvinyl Microspheres Suspended in Polyacrylamide 3.1.2.10 Polytetrafluoroethylene (PTFE) 3.1.2.11 Polyoxyethylene and Polyoxypropylene 3.2 Classification 3.2.1 Biodegradable Facial Fillers 3.2.2 Autologous and Allogeneic Facial Fillers 3.2.3 Xenograft Facial Fillers 3.2.4 Synthetic Facial Fillers 3.2.5 Nonbiodegradable Facial Fillers 3.3 Ease of Use 3.4 Benefits 3.5 Complications References Chapter 4 Hyaluronic Acid Dermal Fillers 4.1 Introduction 4.2 Hyaluronic Acid 4.3 Available Products 4.4 Clinical Indications4.5 Injection Techniques 4.6 Selection Process 4.7 Reversibility of HA Fillers 4.8 Clinical Scenarios 4.8.1 Nasolabial Grooves 4.8.2 Lips 4.8.3 Tear Troughs 4.8.4 Glabella 4.9 Post-Injection Instructions 4.10 Longevity of HA Fillers 4.11 Conclusion References Chapter 5 Radiesse™ Calcium Hydroxylapatite Injectable Filler 5.1 Treatmentin Practice References Chapter 6 Pearls and Pitfalls of Neurotoxins and Facial Fillers 6.1 Pearls and Pitfalls in Neurotoxin Use 6.2 Neurotoxin Preparation and Storage 6.3 Choice of Syringes and Needles
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Pushkar Mehra

Dr. Mehra is Professor of Oral and Maxillofacial Surgery at the Boston University Henry M. Goldman School of Dental Medicine (GSDM). He graduated valedictorian from King George’s Medical College, Lucknow, India, and from the Doctor of Dental Medicine program at GSDM. Dr. Mehra completed his Oral and Maxillofacial Surgery Residency from the combined training program between Boston University and Tufts University. Following graduation, he completed a fellowship in Maxillofacial Reconstructive and Esthetic Surgery under the tutelage of Dr. Larry Wolford at the Baylor University Medical Center in Dallas, Texas. His clinical interests include surgical treatment of obstructive sleep apnea, and complex functional and esthetic facial reconstruction including Orthognathic, TMJ and Cosmetic Surgery. Dr. Mehra is the Editor of three textbooks and has over 100 publications in medical and dental journals and textbooks. He is frequently invited to lecture at national and international meetings. He is a Fellow of the American Association of Oral and Maxillofacial Surgeons, and a Diplomate of the American Board of Oral and Maxillofacial Surgery. In 2009, Dr. Mehra was elected as a Massachusetts delegate to the American Association of Oral and Maxillofacial Surgeons and is presently serving his third consecutive term in that position.
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