Restylane® / Perlane®

In 1893, the first fat auto-grafting was performed by Dr. Neuber, who successfully auto-grafted fat into the infraorbital margin in a man with tuberculous ostitis. In 1980’s Dr. Fournier injected fat from liposuction surgery. Average fat survival rate was around 25%. Bovine collagen was developed in the 1970’s and Zyderm implant was FDA approved in 1983.

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Crow’s Feet

Eyelid skin is thin and elastic, with no underlying subcutaneous fat. Orbicularis oculi, is an elliptical muscle that closes the eyelids and acts as the sphincter of the eye. Orbicularis oculi has three parts: orbital, palpebral and lacrimal. The lacrimal part connects to the lacrimal sac and inserts on the upper and lower eyelids at the tarsal plate.

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Forehead Lines

The vertical frontalis muscle is responsible for the formation of the horizontal forehead lines (HFL). Dysport can be used off-label to smooth these wrinkles. The frontalis muscle inserts into the periocular muscles such as the procerus, corrugator supercilii, orbicularis oculi, and depressor supercilii.

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Glabellar Lines

The glabellar complex consists of the two corrugator supercilii muscles and the procerus muscle. These muscles pull depresses and medially contract the eyebrows. The corrugator supercilii typically lie horizontally from medial eyebrow to near the mid-pupillary position.

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