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Retrograde vs spot botulinium toxin facial injection.

D Labbe1, A Abdulshakoor2, J Fernandez3

  • 1Hôpital privé Saint-Martin, Caen, France.

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|July 29, 2020
PubMed
Summary

Retrograde botulinum toxin injections effectively target facial muscles with diffuse neuromuscular plates, improving results and reducing pain and cost. This method optimizes treatment for varied facial anatomy.

Keywords:
AestheticBotulinum toxinEsthétiqueInjection pointsMode d’injectionToxine botulique

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Area of Science:

  • Aesthetic medicine
  • Neurology
  • Anatomy

Background:

  • Facial musculature exhibits significant anatomical variation in neuromuscular end plate distribution.
  • Understanding this variation is crucial for effective botulinum toxin (BoNT) injection techniques.

Purpose of the Study:

  • To evaluate the efficacy of retrograde botulinum toxin injection via targeted neuromuscular end plate zones.
  • To assess the impact of facial muscle anatomical variation on injection outcomes.

Main Methods:

  • A retrograde injection technique was applied to 10 patients, using the contralateral side as a control.
  • Botulinum toxin (6 Allergan units per zone) was administered perpendicularly to targeted end zones (frontalis, corrugator supercilii, orbicularis oculi).

Main Results:

  • A more prominent effect was observed on day 8 in the orbicularis oculi and corrugator supercilii muscles in 90% of patients.
  • 90% of patients required additional botulinum toxin units for glabellar lines and crow's feet on the control side.
  • One patient (10%) needed reinjection for glabellar lines on the control side.

Conclusions:

  • Facial muscle neuromuscular plate distribution varies, necessitating tailored injection strategies.
  • Retrograde botulinum toxin injections are optimal for muscles with scattered neuromuscular plates.
  • This technique minimizes injection sites, pain, dosage, cost, and off-target product spread.