title: An Evaluation of Use of Botulinum Toxin Type A in the Management of Dynamic Forehead Wrinkles - A Clinical Study.
abstract: BACKGROUND
  The pursuit of youth and beauty has undergone a resurgence of interest which is evidenced by increasing cosmetic procedures. Botulinum Toxin Type A (Botox) is one among the many procedures invented for facial rejuvenation which denervates certain muscles of facial expression responsible for facial wrinkles. It has been applied in the forehead, glabella, lateral canthal area and neck. In maxillofacial area hyperactive forehead wrinkles show sagging.
  
  
  OBJECTIVE
  This study was aimed to clinically evaluate the efficacy of Botox injection in the elimination of hyperdynamic forehead wrinkles and the objectives were to compare pre-operative and post-operative improvement in the number of wrinkles, photographic grading and patient satisfaction responses after 1stweek, 4thweek and 16thweek.
  
  
  METHODS
  A total of 10 patients were randomly included in the present study who were cooperative, motivated and aesthetically conscious with moderate to severe forehead wrinkles. Assessment was performed clinically, photographically (using standardized photographs) and patient satisfaction responses were recorded at 1stweek, 4thweek and 16thweek.
  
  
  RESULTS
  The study showed a significant difference in the elimination of wrinkles at rest and in action when assessed at 1stweek and 4thweek and it was consistent at 16thweek. The patient showed positive satisfaction response without ptosis of the upper eyelid.
  
  
  CONCLUSIONS
  Treatment with Botox is simple, safe and an effective modality for reduction of forehead wrinkles. It offers an alternative management in a cost-effective way when compared to surgical procedures.
authors.affiliation: Postgraduate Student, Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences , Guntur, Andhra Pradesh, India .
authors.forename: Avvaru
authors.initials: A
authors.lastname: Susmita
authors.affiliation: Professor, Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences , Guntur, Andhra Pradesh, India .
authors.forename: Naga Neelima Devi
authors.initials: NN
authors.lastname: Kolli
authors.affiliation: Professor, Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences , Guntur, Andhra Pradesh, India .
authors.forename: Sridhar
authors.initials: S
authors.lastname: Meka
authors.affiliation: Professor, Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences , Guntur, Andhra Pradesh, India .
authors.forename: Srinivas Pandi
authors.initials: SP
authors.lastname: Chakravarthi
authors.affiliation: Reader, Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences , Guntur, Andhra Pradesh, India .
authors.forename: Vivekanand Sabanna
authors.initials: VS
authors.lastname: Kattimani
authors.affiliation: Professor and Head, Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences , Guntur, Andhra Pradesh, India .
authors.forename: Krishna Prasad
authors.initials: KP
authors.lastname: Lingamaneni
authors.affiliation: Postgraduate Student, Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences , Guntur, Andhra Pradesh, India .
authors.forename: Latheef Saheb
authors.initials: LS
authors.lastname: Shaik
keywords: Aging; Esthetics; Facial rejuvenation; Neurotoxin