82 / 86
50. Beer K. Potential foreign body emboli associated with botulinum
toxin A injections. J Drugs Dermatol 2007;6:220–1.
51. Setler P. The biochemistry of botulinum toxin type B. Neurology
2000;55:S22–8.
52. Hexsel DM, De Almeida AT, Rutowitsch M, De Castro IA, et al.
Multicenter, double-blind study of the efficacy of injections with
botulinum toxin type A reconstituted up to six consecutive weeks
before application. Dermatol Surg 2003;29:523–9.
53. Lizarralde M, Gutierrez SH, Venegas A. Clinical efficacy of
botulinum toxin type A reconstituted and refrigerated 1 week
before its application in external canthus dynamic lines. Dermatol
Surg 2007;33:1328–33.
54. Hui JI, Wendy WL. Efficacy of fresh versus refrigerated botulinum
toxin in the treatment of lateral periorbital rhytids. Ophtalm
Plastic Reconstruct Surg 2007;23:433–8.
55. Hexsel D, Rutowitsch MS, de Castro LC, do Prado DZ, et al.
Blind multicenter study of the efficacy and safety of injections
of a commercial preparation of botulinum toxin type A recon-
stituted up to 15 days before injection. Dermatol Surg 2009;
35:933–9.
56. Kane M. Discussion on reconstituted botulinum type A neuro-
toxin: clinical efficacy after long-term freezing before use. Aesth
Plast Surg 2007;31:192–3.
57. Elmas C, Ayhan S, Tuncer S, Erdogan D, et al. Effect of fresh and
stored botulinum toxin A on muscle and nerve ultrastructure. Ann
Plast Surg 2007;59:316–22.
58. Yang GC, Chiu RJ, Gillman GS. Questionning the need to use
Botox within 4 hours of reconstitution: a study of fresh vs 2-week-
old Botox. Arch Facial Plast Surg 2008;10:273–9.
59. Alam M, Yoo SS, Wrone DA, White LE, et al. Sterility assessment
of multiple use botulinum A exotoxin vials: a prospective
simulation. J Am Acad Dermatol 2006;55:272–5.
60. Menon J, Murray A. Microbial growth in vials of Botulinum toxin
following use in clinic. Eye 2007;21:995–7.
61. Sadick N. The cosmetic use of botulinum toxin type B in the upper
face. Clin Dermatol 2004;22:29–33.
62. Callaway J. Botulinum toxin type B (Myobloc): phamacology and
biochemistry. Clin Dermatol 2004;22:22–3.
63. Francisco GE. Botulinum toxin: dosing and dilution. Am J Phys
Med Rehabil 2004;83:S30–70.
64. Klein AW, Kreydenb OP. Storage and dilution of botulinum toxin.
In: Kreyden OP, Bo¨ ni R, Burg G, editors. Hyperhidrosis and
Botulinum Toxin in Dermatology, Vol. 30. Curr Probl Dermatol.
Basel: Karger; 2002. p. 126–30.
65. Bakheit AM. The possible adverse effects of intramuscular
botulinum toxin injections and their management. Curr Drug
Safety 2006;1:271–9.
66. Carruthers J, Carruthers A. Botulinum toxin in facial rejuvena-
tion: an update. Dermatol Clin 2009;27:417–25.
67. Wollina U, Konrad H. Managing adverse events associated
with botulinum toxin type A. Am J Clin Dermatol 2005;6:
141–50.
68. Mantel A. Dilution, storage, and electromyographic guidance in
the use of botulinum toxins. Dermatol Clin 2004;22:135–6.
69. Asher B, Talarico S, Casuto D, Escobar S, et al. International
consensus recommendations on the aesthetic usage of botulinum
toxin type A (Speywood Unit) – part I: upper facial wrinkles. J Eur
Acad Dermatol Venereol 2010;24:1285–95.
70. Garcia A., Fulton J. Cosmetic denervation of muscles of facial
expression with botulinum toxin; a dose response study. Dermatol
Surg 1996;22:39–43.
71. Fulton J. The Newport Beach experience. Dermatol Surg 1998;
24:1219–24.
72. Hankins CL, Strimling R, Rogers GS. Botulinum A toxin for
glabellar wrinkles. Dose and response. Dermatol Surg 1998;24:
1181–3.
73. Hsu J, Dover J, Arndt K. Effect of volume and concentration on
the diffusion of botulinum exotoxin A. Arch Dermatol
2004;140:1351–4.
74. Carruthers A, Carruthers J, Cohen J. Dilution volume of botuli-
num toxin type A for the treatment of glabellar rhytides: does it
matter? Dermatol Surg 2007;33:S97–104.
75. Carruthers A, Bogle M, Carruthers JDA, Dover JS, et al. A ran-
domized, evaluator-blinded, two-center study of the safety and
effect of volume on the diffusion and efficacy of botulinum toxin
type A in the treatment of lateral orbital rhytides. Dermatol Surg
2007;33:567–71.
76. Prager W, Zschocke I, Reich C, Brocatti L, et al. Does dilution
have an impact on cosmetic results with BoNT/A? Complex-
protein-free BoNT/A for treatment of glabella lines. Hautarzt
2009;60:815–20.
77. Boyle MH, McGwin, Flanagan CE, Vicinanzo MG, et al. High
versus low concentration botulinum toxin A for benign essential
blepharospasm: does dilution make a difference? Ophthal Plast
Reconstr Surg 2009;25:81–4.
78. Shaari CM, Sanders I. Quantifying how location and dose of
botulinum toxin injections affect muscle paralysis. Muscle Nerve
1993;16:964–9.
79. Kim HS, Hwang JH, Jeong ST, Lee YT, et al. Effect of muscle
activity and botulinum toxin dilution volume on muscle paralysis.
Dev Med Child Neurol 2003;45:200–6.
80. Shin HI, Han TR, Seo KI. Effects of dilution volume of botulinum
toxin A. J Korean Acad Phys Med Rehab 2000;28:67.
81. Han TR, Shin HI, Han KH. Changes in compound muscle action
potencials according to the dilution volume of BTX type A.
J Korean Acad Rehabil Med 2001;25:273–7. (abstract).
82. Francisco GE, Boake C, Vaughn A. Botulinum toxin in upper limb
spasticity after acquired brain injury: a randomized trial com-
paring dilution techniques. Am J Phys Med Rehabil 2002;81:
355–63.
83. Gracies JM, Lugassy M, Weisz DJ, Vecchio M, et al. Botulinum
toxin dilution and endplate targeting in spasticity: a double-blind
controlled study. Arch Phys Med Rehabil 2009;90:9–16.
84. Lee LR, Chuang YC, Yang BJ, Hsu MJ, et al. Botulinum toxin for
lower limb spasticity in children with cerebral palsy: a single-
blinded trial comparing dilution techniques. Am J Phys Med
Rehabil 2004;83:766–73.
85. Hu GC, Chuang YC, Liu JP, Chien KL, et al. Botulinum
toxin (Dysport) treatment of the spastic gastrocnemius muscle
DERMATOLOG I C SURGERY
HANDL I NG BOTUL I NUM TOX I NS