Use of botulinum toxin type A to prevent widening of facial scars.
BACKGROUND
Wounds of the face, especially those lying perpendicular to the lines of Langer, are known to heal poorly with conspicuous scarring. Different methods have been tried to tackle this problem, including corticosteroid injections, irradiation, ultrasound, silicone applications, and many others. However, as expected, their effects were far from satisfactory, because they do nothing to alleviate the underlying pathologic process, which is the distracting effect of muscle pull on immature collagen.


METHODS
In 40 patients with ugly scars of the face, botulinum toxin was used to induce temporary paralysis of the muscles during revision surgery, thus minimizing tension on healing wound edges until the collagen could mature.


RESULTS
Using both objective and subjective assessment scales, 90 percent of patients ended up with an improved outcome. This new technique has been proven effective in primates and in this study was shown to be as effective in humans, yielding results superior to those of any other treatment modality.


CONCLUSIONS
In view of the results of this study, it is considered worthwhile to offer patients with ugly scars of the face botulinum toxin injections simultaneous with revision surgery.
Wilson
Adel M
AM
Department of Plastic Surgery, Cairo University, Cairo, Egypt. dr_adel_wilson@yahoo.com
D000293:Adolescent; D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002610:Cheek / Q000293:injuries / Q000473:pathology / Q000601:surgery; D002648:Child; D002921:Cicatrix / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D003094:Collagen / Q000737:chemistry; D004341:Drug Evaluation; D004954:Esthetics; D005151:Facial Injuries / Q000150:complications*; D005152:Facial Muscles / Q000187:drug effects* / Q000503:physiopathology; D005153:Facial Neoplasms / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005546:Forehead / Q000293:injuries / Q000473:pathology / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000187:drug effects*; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D017060:Patient Satisfaction; D012904:Smiling; D013314:Stress, Mechanical; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D003094:Collagen; D019274:Botulinum Toxins, Type A