Dr. Blumin said he would not normally do an EMG but might if the patient agrees. “I usually present that to the patient, saying that it’s sort of an academic exercise, and we would see if you have some kind of bilateral involvement,” he said. “However, I would treat what clinically seems to need to be treated, which appears to be the left side.”
Explore This IssueOctober 2012
Most of the panel said that they used to prefer Zyplast as the injection material, but it’s been off the market for two and a half years—removed by the manufacturer strictly for financial reasons, said Dr. Simpson. Dr. Merati said he “felt like I lost a friend that day.” Now, they tend to use Restylane, largely for its feeling of “cushioning” compared with some other agents.
Panel members agreed that the length of time a material will last after being injected is hard to predict from patient to patient, regardless of which material is used. “I’ve seen it happen variably with all these materials,” Dr. Johns said. “And I’ve tried them all, so I think they’re largely substitutable.”