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  • Presentation

Aesthetic Ergonomics and Brow Shaping with Botulinum Toxin

Description

In this presentation, dermatologist Jeremy Green discusses aesthetic ergonomics and brow shaping techniques using botulinum toxin, aimed at enhancing patient comfort and treatment efficacy. He introduces the concept of the "gate theory of pain," explaining how vibration can be used to reduce discomfort during cosmetic procedures. Green emphasizes the importance of patient positioning, ergonomics, and equipment, like using vibration for comfort during injections. He provides practical tips on injecting techniques, including using specific needle sizes and proper body positioning for optimal results. He highlights findings from a neuromodulator trial, illustrating varying outcomes between different injection styles and stressing the need to understand individual anatomy for effective brow shaping. The presentation offers a modified approach to the traditional globellar frown line treatment to minimize brow lowering while achieving desired aesthetic results. Overall, Green encourages practitioners to focus on comfort, technique, and individualized patient needs to optimize outcomes in aesthetic dermatology.

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Conclusions

  • Incorporating vibration and other comforts during procedures enhances patient comfort and may improve outcomes.
  • Understanding the gate theory of pain can significantly affect the management of patient discomfort during dermatological procedures.
  • Using vibration on bony prominences proves effective in providing distraction and pain relief during injections.
  • Proper ergonomic practices in height, lighting, and patient positioning contribute to more comfortable and efficient procedures.
  • The choice of needle size can impact patient comfort during injectable procedures, favoring smaller gauge needles when possible.
  • Injection techniques must adapt to individual patient anatomical differences to optimize aesthetic outcomes and minimize complications.
  • Modified injection patterns for glabellar frown lines can enhance brow positioning and avoid unwanted aesthetic results such as brow ptosis.
  • Clinical outcomes vary significantly based on injection techniques, emphasizing the importance of individualized approaches in aesthetic dermatology.
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  • Akintilo L, Green JB, Kaufman J, Ghane-Motlagh B, Freytag DL, Frank K, Alfertshofer M, Cotofana S. When to change needles during neuromodulator injections-An electron-microscopy investigation into needle tip deformation. J Cosmet Dermatol. 2025 Jan;24(1):e16506.
  • Pineiro ML, Green JB, Kaufman J, Blackwelder PL, Freytag DL, Frank K, Alfertshofer M, Cotofana S. Deformation of Needle Tips During Facial Soft Tissue Filler Injections: An Electron-Microscopic Study. Aesthet Surg J. 2021 Nov 12;41(12):NP2011-NP2019.
  • Bertucci V, Green JB, Fezza JP, Brown J, Gallagher CJ, Solish N. Impact of Glabellar Injection Technique With DaxibotulinumtoxinA for Injection on Brow Position. Aesthet Surg J. 2023 Nov 9;43(Suppl 1):S10-S18. Erratum in: Aesthet Surg J. 2022 Dec 30.