Botulinum Toxin Injections for Leg Contouring in East Asians

Cheng, Judy; Chung, Hye Jin; Friedland, Matthew H.; Hsu, Sarah

doi:10.1097/dss.0000000000002320

Cited by 20 publications

(22 citation statements)

References 22 publications

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“…Enlarged, muscular calves, shoulders, and upper arms are a unique esthetic concern among many Asian women, especially for the younger generations, and many prefer to slim them down [ 9 , 10 ]. BoNT-A injections have been reported to be an effective and safe option to non-surgically reduce the size and reshape the contour of the calves (gastrocnemius muscles) and the shoulder (trapezius, deltoid, and biceps muscles) [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

An Update on the Cosmetic Use of Botulinum Toxin: The Pattern of Practice among Korean Dermatologists

Rho

Han²,

Kim

2022

Toxins

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The efficacy and safety of botulinum toxin injection have made it a popular aesthetic procedure worldwide. A cross-sectional survey was performed in order to determine the pattern of type A botulinum toxin injections in cosmetic practice, for which an 18-item questionnaire was distributed to dermatologists. A total of 469 Korean board-certified dermatologists participated in the survey, with the following results: the main candidates for type A botulinum toxin injection were individuals in their 40–50 years (46.1%), followed by those in their 20–30 years (33.4%), and people over 60 years of age (20.5%). Overall, the upper face (the glabella, forehead, and crow’s line, in decreasing order) was the most favored area of injection (51%). In contrast, body contouring (i.e., shoulder, calf) and treatment for benign masseter hypertrophy were significantly more popular in the 20–30 years age group than their older counterparts. For wrinkle effacement, the most preferred dilution was 100 units/2.5 mL with isotonic sodium chloride injection (51.2%), and the most often used interval was six months (43.6%). About half (46.3%) of the dermatologists reported the experience of clinical cases which were suspicious of botulinum toxin resistance. Despite this, regarding the choice of the product, type A botulinum toxin products with greater cost-effectiveness were favored over products with a lower risk of antibody formation. Other than its cosmetic usage, botulinum toxin is applied for a variety of skin conditions. Further studies are suggested in order to identify the practice pattern of type A botulinum toxin for therapeutic uses in dermatology, such as hyperhidrosis and rosacea.

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Section: Discussionmentioning

confidence: 99%

An Update on the Cosmetic Use of Botulinum Toxin: The Pattern of Practice among Korean Dermatologists

Rho

Han²,

Kim

2022

Toxins

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“…Though BoNT‐A injection to soleus muscle is not as common as to gastrocnemius muscle, it has been illustrated that patients could benefit from paralyzing soleus muscle. Cheng et al 16 recommended injection to the lower soleus muscle if there is prominent soleus near the Achilles tendon. Another study hypothesized that solely paralyzing gastrocnemius muscle resulted in compensatory soleus muscle hypertrophy as calf circumference decrease was not dose‐dependent 17 .…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic analysis of the calves for efficient botulinum toxin type A injection

Chong

Zhang

et al. 2022

J of Cosmetic Dermatology

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According to the aesthetic standards of Asians, having large calves is considered a hindrance to lower leg beauty. Botulinum toxin type A (BoNT-A), functioning as a synaptic junction blocker to reduce muscle contraction, is widely used to treat muscle hypertrophy, and its efficacy has been demonstrated by previous studies in young Asians. 1 Different from small-size muscles like masseter, gastrocnemius muscle (GM) is a relatively large muscle that is difficult to be totally covered by BoNT-A. To obtain a better outcome, multiple injection protocols have been executed and revised by different researchers to paralyze gastrocnemius muscle as evenly as possible. This requires a profound knowledge of the morphology of gastrocnemius muscle. [2][3][4] However, our major perception of the gastrocnemius muscle mainly originated from cadaveric anatomical data. The anatomical information in the living body remains unknown. B-mode ultrasound imaging is a cost-effective method to acquire real-time visualization of a patient's anatomical structure, which has been used to access the effectiveness of BoNT-A injection by measuring muscle thickness change. [4][5][6] Yet, the specific baseline data is rarely disclosed in detail. This study, therefore, applies ultrasonography intending to

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“…Previous studies on calf muscles also displayed a relatively lower degree of satisfaction compared to those for masseter muscles. [8][9][10][11] This may be explained by the masking of the reduction in muscle size by the thick subcutaneous fat tissue. To increase patient satisfaction, additional comparative studies on the (1) injection location and dosage and (2) combinations with other procedures such as cryolipolysis and injection lipolysis need to be conducted.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of botulinum toxin injection in reducing deltoid muscle hypertrophy

Shin

Park

Yeoum

et al. 2021

Dermatologic Therapy

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With the increasing demand for body contouring, botulinum toxin (BTX) injection is being widely used off-label for muscular hypertrophy. However, to the best of our knowledge, no study has investigated the clinical efficacy of BTX type A (BTX-A) in deltoid muscle hypertrophy. This study was conducted to evaluate the efficacy and safety of intramuscular injection of BTX in reducing deltoid muscle hypertrophy.Overall, 10 patients with bilateral deltoid muscle hypertrophy were treated with an intramuscular injection of prabotulinum toxin A, with a total of 50 units [U] administered per patient. As measured by ultrasonography, the thickness of the deltoid muscles was significantly decreased at weeks 2 and 12. In addition, the clinical assessment score by blinded investigators was improved after the treatment; however, patients' satisfaction scores were relatively low. No major complications were reported. Therefore, intramuscular injection of BTX-A seems to be a candidate for novel treatment option for deltoid muscle hypertrophy. Further larger clinical studies are warranted to confirm the efficacy of BTX-A.

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Botulinum Toxin Injections for Leg Contouring in East Asians

Cited by 20 publications

References 22 publications

An Update on the Cosmetic Use of Botulinum Toxin: The Pattern of Practice among Korean Dermatologists

An Update on the Cosmetic Use of Botulinum Toxin: The Pattern of Practice among Korean Dermatologists

Ultrasonographic analysis of the calves for efficient botulinum toxin type A injection

Efficacy and safety of botulinum toxin injection in reducing deltoid muscle hypertrophy

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