Air bubbles in the syringe barrel are expelled and the syringe is attached to an appropriate injection needle. Patency of the needle should be confirmed. A new, sterile needle and syringe should be used to enter the vial on each occasion for removal of BOTOX.
Limiting the dose injected into the sternocleidomastoid muscle may reduce the occurrence of dysphagia. Injections into the levator scapulae may be associated with an increased risk of upper respiratory infection and dysphagia.
Depending on patient symptoms, institute catheterization if PVR urine volume exceeds 200 mL and continue until PVR falls below 200 mL. Instruct patients to contact their physician if they experience difficulty in voiding as catheterization may be required.
Please see the Patient Information Guide available at for list of these events. Tell your health care provider about any side effects that bother you or do not go away.
Each injection site has a ring of effect of up to approximately 2 cm in diameter. To minimize the area of no effect, the injection sites should be evenly spaced as shown in Figure 6.
Dosing in initial and sequential treatment sessions should be tailored to the individual based on the size, number and location of muscles involved, severity of spasticity, the presence of local muscle weakness, the patient’s response to previous treatment, or adverse event history with BOTOX.
After the injections are given, the saline used for bladder wall visualization should be drained. The patient should be observed for at least 30 minutes post-injection.
Limitations of Use BOTOX has not been shown to improve upper extremity functional abilities, or range of motion at a joint affected by a fixed contracture. 1.5 Cervical Dystonia
If injection sites are marked in ink, do not inject BOTOX directly through the ink mark to avoid a permanent tattoo effect.
The injection needle should be filled (primed) with approximately 1 mL of reconstituted BOTOX prior to the start of injections (depending on the needle length) to remove any air.
Xeomin and Botox both contain botulinum toxin type A, but each has distinctive characteristics that may benefit different patient populations. Xeomin's pure formulation radiesse without complexing proteins potentially offers advantages for long-term treatment and for patients concerned about developing resistance.
RADIESSE® is also used for correcting volume loss in the back of the hands. RADIESSE® (+) is also used for improving moderate to severe loss of jawline contour in adults over 21 years old.
Calcium hydroxylapatite, or CaHA, is what makes Radiesse unique as a dermal filler treatment. Radiesse is composed of CaHA suspended in an aqueous gel copyright.3
Have a thorough consultation to discuss your goals and allow the injector to assess your specific muscle strength and anatomy.