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Does Linear or Spot Injection Technique Matter in Upper Face Botulinum Toxin Type A Application? A Split-Face

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Retrograde linear injection of botulinum toxin type A (BoNTA) improved forehead and glabellar wrinkles more than spot injections. However, spot injections were more effective for periorbital wrinkles, with no difference in pain or muscle activity.

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Area of Science:

  • Dermatology
  • Aesthetic Medicine
  • Plastic Surgery

Background:

  • Efficacy of botulinum toxin type A (BoNTA) can be influenced by injection technique.
  • The impact of injection pattern on BoNTA outcomes is not well-documented.

Purpose of the Study:

  • To compare the therapeutic effects of retrograde linear versus traditional spot injection techniques for BoNTA treatments.
  • To evaluate wrinkle improvement, muscle activity, and pain associated with different BoNTA injection patterns.

Main Methods:

  • A split-face, patient-blinded randomized clinical trial involving 28 participants.
  • BoNTA was administered using linear injection on one side and spot injection on the contralateral side.
  • Outcomes measured included wrinkle improvement rates (WIRs) via 3D camera, ultrasound muscle activity, and pain scores.

Main Results:

  • Linear injection showed significantly higher WIR for forehead wrinkles at 1 week and 1 month, and for glabellar wrinkles at 1 week.
  • Spot injection demonstrated significantly higher WIR for periorbital wrinkles at 1 week.
  • No significant differences were found in muscle contraction or pain scores between the two techniques.

Conclusions:

  • Retrograde linear injection is more effective than spot injection for forehead and glabellar lines.
  • Spot injection is more effective for periorbital lines when using the same BoNTA dosage.
  • Injection pattern significantly impacts BoNTA efficacy for different facial areas.