Kırışıklık Tedavisi
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- Kırışıklık Tedavisi
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Kırışıklık Tedavisi sanılanın aksine yılan zehiri olmayıp Clostridium botulinum adlı, doğada bulunan bir bakterinin toksinidir (Botulinum Toksin Tip A). Bu bakteriden laboratuvar ortamında elde edilen toksin saflaştırılıp seyreltilerek ilaç şeklinde flakonlanmaktadır.
Türkiye’de, Çin veya Hint malı ürünler dışında, Amerika ve Avrupa kaynaklı 3 değişik markada botulinum toksini kullanılmaktadır. Kırışıklık tedavisi aslında Allergan firmasının ürettiği botulinum toksininin piyasa ismi olmasına rağmen ilk çıkan ürün olduğu için genel olarak botulinum toksinlerin hepsine kullanılan bir isim haline gelmiştir. Diğer marka isimleri Dysport ve Neurobloc’tur.
Yapılan araştırmalarda C. Botulinum adlı mikroorganizmanın toksininin geçici kas felci yaptığının saptanmasından sonra, kırışıklık tedavisi ilk kez ortopedistler tarafından spastik kasları gevşetmek amacıyla, göz hekimleri tarafından da şaşılık tedavisinde kullanılmıştır. Zaman içinde mimik çizgilerine sebep olan yüz kaslarının hareketlerini engellemek amacıyla da kullanılabileceği öngörülmüş ve bu amaçla FDA onayı alınarak estetik kullanıma girmiştir. Şu anda tüm dünyada en çok yapılan ameliyatsız estetik uygulamasıdır.
Yüz derisindeki kırışıklıklar mimiklerimizi yapmak için kullandığımız kasların kasılması sonucu oluşur. Herkes aynı mimikleri aynı sıklıkta yapmadığı, cilt kalınlıkları ve yapısı aynı olmadığı için için bu kırışıklıkların veya çizgilerin oluşmaya başladığı yaş ve yerleri de birebir aynı değildir. Kaşlarını çatma eğiliminde olan kişilerde 20 yaşında bile kaş arası çizgileri oldukça belirgin hale gelebilir. Gözlerini kısarak gülümseyen veya gözleri güneşe çok hassas olduğu için sürekli gözleri kısık olan kişilerde de çok erken yaşlarda kazayağı denilen çizgilenmeler oluşabilir. Konuşurken alın kaslarını çok kullanan kişilerde alında yatay çizgilenmeler oluşabilir. Bazı kişilerde yaşlanmaya bağlı, bazılarındaysa genetik nedenlerle kaş kenarlarında düşüklük olabilir. Bu düşüklük ameliyatla tedavi edilebildiği gibi, ameliyat için zamanı olmayanlarda veya ameliyattan çekinen kişilerde kırışıklık tedavisi ile kaşların kenar kısımlarının kalkması sağlanabilir. Botulunium Toxin A özellikle alın bölgesindeki yatay çizgiler, kaşların arasındaki dikey çizgiler ve kazayağı denilen göz kenarındaki kırışıklıklarda ve kaş kaldırmak için uygulanan bir tedavi yöntemidir.
Botulinum toksin, istemediğimiz mimiğe neden olan kasın içine enjekte edildiğinde geçici bir süreliğine kasın kasılma fonksiyonunu azaltır veya durdurur ve böylece kasın üzerindeki deri kırıştırılamadığı için düzleşir. Kırışıklık Tedavisi uygulaması poliklinik şartlarında yapılabilen kolay bir enjeksiyon işlemidir. Enjeksiyon yapılan bölgelerde yarım saat içinde geçen hafif bir şişlik ve kızarıklık oluşabilir. İlacın etkisi genellikle 2-3 gün sonra ortaya çıkmaya başlar ve 7-10 gün içinde tam olarak oturur. İlk uygulamadan sonra çoğunlukla etkisi 4 ay sürer, mükerrer uygulamalarla bu etki süresi 8 aya kadar uzayabilir. Yapılan dozun miktarı, yeri, kaçıncı sefer yapıldığı da süreyi etkileyen faktörlerdir.
Bazı nörolojik hastalıkları bulunanlarda, hamilelerde ve emzirenlerde kırışıklık tedavisi uygulaması yapılmamalı, asprin/ kan sulandırıcı ilaç kullananlarda ve enjeksiyonun yapılacağı bölgelerde aktif enfeksiyonu olanlarda, kan sulandırıcı ilaç bırakıldıktan ve/veya enjeksiyon bölgesindeki enfeksiyon tedavi edildikten sonra kırışıklık tedavisi uygulanmalıdır.
Botulinum toksinin kozmetik uygulama dozlarında vücuda yayılması söz konusu değildir. Allerjik şikâyetler tüm dünyada yok denecek kadar azdır. Botulinum toksinin yan etkileri uygulama alanına bağlı olarak, gözkapağında düşmedir. Bazı damlalarla bu düşüklük 2-3 haftada tedavi edilebilir.
Botulinum toksinin etkisi altındaki bölgelerde yeni kırışıklıkların oluşması veya var olan kırışıklıkların derinleşmesi mümkün değildir.
Günümüzün yoğun iş temposunda oradan oraya yetişmeye çalışırken en son ihtiyacımız olan şey kontrolsüz terlemedir. Hemen herkes güne başlarken gün içinde terlemeyi kontrol altında tutmak amacıyla “anti-perspiran” olarak da adlandırılan, deodorant ürünlerinden faydalanmaktadır. Ancak bazıları için bu ürünler yeterli olamamaktadır ve kişi gün içerisinde aşırı terlediğini, rahatsız olduğunu fark etmektedir. Hiperhidrozis olarak adlandırılan ve aşırı terleme anlamına gelen bu durum için artık kolay bir çözüm bulunmaktadır. Sıklıkla yüzümüzdeki mimik çizgileri ve kırışıklıkların giderilmesinde uygulanan botulinum toksin A, hiperhidrozis tedavisinde de kullanılmak üzere FDA onayı almış bir üründür.
Botulinum toksin A, ticari olarak Botox® veya Dysport® olarak da sıklıkla bilinmektedir. Botulinum toksin A bir nörotoksindir ve tıpkı sinirlerden kaslara olan iletimi bloke ederek mimik kaslarını zayıflattığı gibi, sinirlerden ter bezlerine uyarının iletimini de bloke eder ve bu sayede ter bezlerini aktive eden uyarılar iletilemediği için terleme olmaz. Kişi bu sayede kendisi konforlu, rahat ve kuru hisseder.
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