Botox® injection & Aptos® thread: An alternative in delaying upper lid blepharoplasty among asians

Introduction: BOTOX® purified neurotoxin complex is a form of purified botulinum toxin type A which blocks neuromuscular conduction through binding of receptor sites on motor nerve terminal and consequently, results to the inhibition of acetycholine release. Intramuscular injection at therapeutic doses produces a localized chemical denervation muscle paralysis. Thus, this has been utilized in the reduction of excessive abnormal contractions associated with blepharospasm. Botox is also indicated for treatment of strabismus. Other benefits of this exotoxin has been implicated in palmar hyperhidrosis, axillary hyperhidrosis, facial dystonia, conditions such as migraine and anal fissures and for cosmesis. It has also been used to cosmetically to treat frown lines, orbital wrinkles, platysmal bands, ptotic brows, brow asymmetry as well as adjunct therapy to laser resurfacing. Clearly, Botox injected into the orbicularis oculi, albeit temporary, has shown to have increased palpebral fissure giving the eyes a widened appearance. This effect was more noticeable in the Asian eyes. On the other hand, APTOS® thread is a low-weight, high-resistance plastic threads made of 2.0 polypropylene suture material that has unidirectional dents or cogs designed to anchor itself to the subcutaneous tissue and allow the lifting of sagging anatomical structures. Sulamanidze, et al. (2001) has reported the excellent and long lasting effects of APTOS® threads in facial lifting. The use of these unique threads for lifting ptotic tissues of the face and neck has been suggested as an alternative to the classic techniques of facial cosmetic surgery, with it being a simpler technique that leaves no visible scars. Significance: This research entails a clinical series, which aims to assess the effectiveness of Botox injection in delaying upper blepharoplasty. A case report on the use of APTOS® thread as an alternative has also been included. In effect, these alternative methods provide individuals seeking an improvement in the brow-upper eyelid distance less invasive options.

Patient Selection: Subjects aged 30–55 years were selected [abstract truncated at 300 words]