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肉毒桿菌注射

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肉毒桿菌製劑(CORETOX®、コアトックス)

CORETOX®是一種由肉毒桿菌產生的毒素(肉毒桿菌毒素)所製成的藥物。 它可以放鬆面部肌肉收縮進而改善皺紋。 當注射到咀嚼肌和小腿肌肉時,它可以用來縮小臉部和腿部的肌肉而達到瘦臉或瘦腿的效果。它還能減少汗液和鼻水分泌,進而改善腋窩、手腳的多汗症和花粉症的症狀。

肉毒桿菌注射的適應症和部位

肉毒桿菌注射的好處

  • 通過將其註射到您的臉上,您可以改善皺紋並改善鰓的張力,從而使您的臉變小。
  • 通過注射到腋窩、手掌和腳底來改善多汗症。
  • 通過注射到肩膀和小腿,改善肩膀僵硬,瘦腿。
  • 通過將其塗抹在鼻子上,它可以改善由花粉熱和鼻炎引起的流鼻涕。
  • 通過精細注入皮膚(Microbotox),它可以抑制皮脂。

CORETOX特徴

我們的診所使用韓國公司medytox生產的CORETOX。以前,我們也處理日本艾爾建(Allergan)生產的Botox Vista,但我們不再這樣做,因為許多患者更喜歡CORETOX。

CORETOX

CORETOX是一種使用與Botox Vista相同的肉毒桿菌菌株的製劑,不含「人類血清白蛋白」和「動物來源的材料」。此外,通過去除「複合蛋白質」,減少了產生抗體(耐受性)的風險。此藥物在韓國有通過MFDS的承認,但在日本仍為未經厚生勞動省承認的藥物,因此在重度副作用出現時,無法使用日本國內的《藥品不良反應賠償制度》。

CORETOX和BOTOX VISTA的比較
CORETOXBOTOX VISTA
菌株Hall Hyper 菌株Hall Hyper 菌株
日本國內承認尚未已承認
人類血清白蛋白不含含有
動物來源的材料不含含有
複合蛋白質去除含有

如果您想了解更多關於美容醫學中使用的肉毒桿菌毒素製劑,請參閱以下文章。

用於肉毒桿菌注射的針頭

在我們的診所,我們使用最細的34G(直徑0.18毫米)顯微注射針。通過使用盡可能細的針頭,可以最大限度地減少疼痛和內出血。(我們對鰓使用33G針,對小腿使用30G針)

34G針粗細對比

治療效果持續時間及治療間隔

治療效果可能因人而有所差異,以下說明僅提供一般狀況之參考。

  • 皺紋:通常於3-4天後開始出現效果,2週後可達到最大效果,並持續3-4個月;建議每隔3-4個月治療一次,如果希望預防永久性皺紋發生,建議每6個月至1年接受一次注射治療。
  • 咀嚼肌瘦臉治療:通常於1-2週後出現一些咀嚼時感到疲倦等注射後症狀,但會隨著時間慢慢改善;大約經過1個月咀嚼肌會慢慢變小,但只治療一次可能效果不如預期,所以一般建議間隔3-6個月連續接受肉毒桿菌注射3次,之後如果覺得咀嚼肌大小又回復時可再追加進行注射治療。於日常生活也請儘量注意不要過度咬合或咀嚼刺激咀嚼肌發達。
  • 肩頸僵硬:對於僵硬的肩部,通常於治療數日後效果出現,但只有一次的注射可能無法有效維持治療效果,因此一般建議每3-4個月注射一次,以改善肩頸僵硬。
  • 水牛肩瘦肩治療:通常在2週至1個月左右肌肉縮小效果顯現,但只有一次注射可能無法有效維持治療效果,因此當肌肉恢複到原來大小之前,每6個月注射一次。
  • 瘦小腿治療:通常在一個月後肌肉縮小效果顯現,但只有一次注射可能無法有效維持治療效果,所以建議間隔3-6個月連續注射三次。 由於腿部肌肉每天都在使用,因此肌肉大小一般在6個月到1年左右會恢複,因此建議有需要時再進行追加治療。
  • 花粉症:隨著流鼻水症狀的改善,鼻塞、打噴嚏和眼睛癢的情況也會有所緩解。效果通常在幾小時後出現,可持續2-3週左右。 於花粉症的時期建議每2~3星期治療一次。
  • 腋下多汗:一般於治療3天後逐漸出現效果,50單位的注射一般可持續3-6個月,100單位的注射則可持續約6-9個月。 如果在春季接受100單位注射治療,一整年中較溫暖的月份都可有效控制出汗症狀。
  • 手腳多汗:一般於治療3天後逐漸出現效果,大約可持續3~6個月。
劑量和治療時間間隔

一次注射的最大劑量為200單位(小腿為300單位)。少於50單位的注射,沒有間隔時間的限制;但如果一次注射超過50個單位,包括微量矯正的劑量,建議至少間隔三個月的時間,以防止抗體產生。

無法接受CORETOX治療的對象

  1. 吞嚥困難、呼吸道疾病病史、有癲癇發作史、神經肌肉疾病或全身性重度肌無力者(如重症肌無力、Lambert-Eaton肌無力症候群、肌萎縮性脊髓側索硬化症等)。
  2. 懷孕、哺乳或有計畫懷孕的女性。
  3. 過去對肉毒桿菌治療或polysorbate(添加劑)有過敏史者。
  4. 有隅角閉鎖型青光眼或有其誘發因素(如有較窄隅角)的人。

CORETOX治療後的注意事項

  1. 避免摩擦、搓揉或按壓注射部位。
  2. 在注射後3小時內,請稍為刻意收縮治療部位的肌肉以產生些微皺紋,讓藥物能更平均擴散。
  3. 避免在治療後當天泡熱水澡、按摩、劇烈運動或飲酒。淋浴和化淡妝則不受限制。
  4. 女性請採取避孕措施,至少須持續到注射後第二次月經結束。 男性在注射後三個月內也須採取避孕措施
  5. 注射後一週內請不要捐血。

Common side effects for all treatments

  • Redness, swelling, pain, and heat at the injection site: Usually improves within a few hours to a day.
  • Internal bleeding: Very rare. It will disappear 1-2 weeks after treatment.
  • Headache: Occurs in 1~5% of patients. It is usually mild and will disappear in a few hours to few days.

Risks and precautions according to the treatment area

  • For all wrinkle treatments: Muscle movements may change and wrinkles may appear in other areas. It is important not to increase the dosage of CORETOX too much, as it will fully fulfill its anti-wrinkle effect if wrinkles are prevented from appearing with the facial expressions that are often performed on a daily basis.
  • Forehead and Frown lines (areas between eyebrows): Eyelid and eyebrow drooping (eyelids and eyebrows droop, eyes become heavier, and difficult to open the eyes) and eyebrow elevation (the outer eyebrows become lifted and there is a difference between the left and right eyebrows) may occur. Rarely, the width of double eyelid may narrow or change. Generally, all the symptoms will gradually improve in about 4 weeks. CORETOX injection to the areas between eyebrows may cause the muscles relax and the space widen. Forehead CORETOX treatment is not recommended for people in their 60s and older.
  • Crow’s feet (the corner of the eye): Brow elevation (lifting of the outer brow) and dry eyes have been reported in few patients.
  • Bunny lines: Although very rare, symptoms of double vision and running tears (watery eyes) have been reported.
  • Gummy smile: The philtrum (the indentation above the upper lip) may be elongated and the left and right corners of the mouth may become asymmetrical. When the left and right become asymmetrical, additional injections are made on the side that is elevated to correct the asymmetry.
  • Smile lines on the cheeks: Smiling may become unnatural or asymmetrical. Usually improves in 2~4 weeks.
  • Lips: Mouth squeezing movements and whistling may become difficult. It may be also difficult to pronounce “pa, pi, pu, pe, and po”.
  • Jaw: Mouth may become difficult to close, jaw may become elongated, and mouth may become distorted when smiling. The lower lip may become more easily caught between the teeth and the lower lip, or the lower lip may be bitten more easily.
  • Corner of mouth: Asymmetry of the left and right corners of the mouth may occur, and mouth may be distorted when smiling. Usually improves in 2~4 weeks.
  • Platysma muscle: Although very rare, the muscles in the center of the neck may relax and sag. Speech, swallowing, and movement disorders have been reported.
  • Masseters: This treatment is not recommended for people in their 40s or older, as the decrease size of masseter muscles can cause the skin to sag in their place and the cheeks to become hollow. Some muscles may bulge compensatory, and additional corrective CORETOX injections are used in these cases.
  • Shoulder and calf: Dull muscle pain, sagging, weakness, wobbliness, and tangling may occur, but will improve in 2~3 weeks. Decreased in strength may occur. Very rarely, neuropathy, numbness, and weakness may also occur.
  • Hay fever: Although the possibility of transient effects on the sense of smell cannot be ruled out theoretically, it is very rare in actual clinical practice.
  • Hyperhidrosis: Instead of a decrease in sweating in the treated area, there may be an increase in sweating from other areas (compensatory sweating). In the cases of hands or feet treatment, transient weakness, difficulty grasping objects, difficulty doing fine work, muscle pain, and numbness due to neuropathy may occur.

Severe side effects

Although very rare, the following side effects have been reported

  • Anaphylactic shock: Severe allergic symptoms (generalized rash, swelling of skin, lips, and tongue, dyspnea, palpitations, hypotension, disorientation, and convulsions).
  • Allergy to anesthesia or its ingredients or additives: Severe allergic symptoms (generalized rash, swelling of skin, lips, and tongue, dyspnea, palpitations, hypotension, disturbance of consciousness, convulsions) after using lidocaine tape or cream anesthesia.
  • Eye disorders: Corneal disorders due to difficulty in closing the eyes and dryness of the cornea.
  • Swallowing and breathing disorders: Symptoms such as dysphagia, change in voice quality, and dyspnea may occur after injections of 100 units or more into the neck muscles.
  • Seizures: seizures and recurrence of seizures may occur.

Other side effects

Other reported side effects include. There are specific side effects depending on the area of wrinkles treated, which will be explained in detail during the consultation.

Less than 1%Frequency unknown
Excessive muscle relaxationRabbit eyes, facial paralysis, localized hypotonia (cervical muscle weakness, drooping corners of the mouth, etc.)Ectropion, entropion, eyelid closure problems
EyeDiplopia, foggy eyesight, photophobia, eye fat, watery eyes, eye painEye irritation, strabismus, conjunctivitis, dry eyes, keratitis, corneal erosions, Impaired vision, eyelid edema
SkinRash, itching, erythema, hair loss (including eyelash and eyebrow depilation)Psoriasiform eruption, Erythema multiforme
Injection siteSwelling, hemorrhagic spots, burning sensation, or pain at the injection siteTwitching or infection at the injection site, pain and hypertonia of neighboring muscles
BloodDecreased white blood cellsThombocytopneia
Gastro intestineNausea, diarrhea, dry mouthDysphagia, anorexia, vomiting, abdominal pain
Psychiatric, neurologicalDizziness, fainting, sensory abnormalityNerve root disorders, numbness
OthersFacial pain, fever, CK level elevation(blood test), common cold-like symptomsWeakness, fatigue, tinnitus, hearing loss, sweating, denervation atrophy/muscle atrophy, myalgia, abnormal liver function tests

治療費用

診察費用・其他(含稅價格)
診察費用初診費 ¥3,850
再診費 ¥1,650
麻醉費用局部麻醉貼片(1片)¥330
麻醉軟膏 ¥3,300
  • ※注射前須要由醫師診察、毎次診察會收取診察費用。
皺紋(含稅價格)・免費微量矯正(touch-up)
微量矯正
(touch-up)
免費
皺鼻紋
(兔寶寶紋)
¥24,860
微笑時牙齦露出改善
口周紋
(楊婆婆紋)
口角紋
(木偶紋)
(嘴角提升)
下巴皺紋
(下頷肌肉過度緊張)
額頭抬頭紋¥29,810
眉間皺眉紋
魚尾紋
兩頰微笑紋
頸紋¥49,500
  • 上述皺紋治療對同一部位在兩週後可免費施行一次微量矯正touch-up(微量矯正仍須收取診察費用)。抗肉毒桿菌毒素Acetylcholine Chloride緩解劑則可最多可以免費注射三次。
  • 治療後三週後(如果三週後剛好遇上休診日,則期限為前一天)的微量矯正。 如果因為預約額滿無法於三星期內再診,則微量矯正追加治療將收取費用,因此建議您於治療後儘早預約。
  • 免費微量矯正不適用於咀嚼肌瘦臉、瘦小腿、肩頸僵硬、花粉症、多汗症和微量肉毒注射等治療。
咀嚼肌瘦臉・肩頸僵硬・瘦小腿・花粉症(含稅價格)
咀嚼肌
(瘦臉治療)
50單位 ¥34,980
80單位 ¥49,500
肩頸僵硬
(水牛肩治療)
50單位 ¥34,980
100單位 ¥55,000
150單位 ¥73,700
小腿肌
(瘦小腿治療)
100單位 ¥55,000
200單位 ¥88,000
300單位 ¥117,700
花粉症16單位 ¥14,850
24單位 ¥19,800
多汗症(含稅價格)
腋下50單位 ¥44,000
100單位 ¥64,900
腳底150單位 ¥79,200
200單位 ¥93,500
手掌100單位 ¥64,900
150單位 ¥79,200
  • 建議您接受治療前事先將腋下進行剃毛或修剪,以使治療能順利進行。在有毛髮的狀態下仍能夠接受腋下肉毒桿菌注射,因此無須完全除去腋毛。
微量肉毒注射(含稅價格)
微量肉毒注射5單位 ¥24,200
10單位 ¥27,500
20單位 ¥34,100
30單位 ¥40,700

如何預約

肉毒桿菌注射治療的預約只能通過電話進行,因此請致電各診所。

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