Different injection patterns of incobotulinumtoxinA for crow’s feet: a split‐face comparative study

Abstract

BackgroundIncobotulinumtoxinA has been previously used for the treatment of lateral periorbital lines (crow’s feet). However, a standardized injection technique has not been established.ObjectivesTo compare the efficacy and effect duration of two injection techniques of incobotulinumtoxinA for crow’s feet treatment.MethodsForty‐eight patients with crow’s feet were recruited and randomly assigned to receive bilateral treatments using either a 3‐point intramuscular or a 6‐point intradermal injection technique (8–12 units of incobotulinumtoxinA on each side). Improvement was assessed at 1, 2, 4, 8, 12, 16, 20 and 24 weeks postinjection. An objective evaluation was assessed by the indentation index using a 3D camera and a subjective evaluation was assessed by a blinded dermatologist using the Flynn validated assessment scale (FVAS) for the upper face. The patients assessed the results using the Global Aesthetic Improvement Scale (GAIS). Side‐effects were evaluated at each visit.ResultsAfter treatment, a significantly greater reduction in the indentation index of periorbital wrinkles on the 3‐point intramuscular injection side compared with the 6‐point intradermal injection side was observed at 8, 12, and 16 weeks. The results from the FVAS and GAIS scores showed significantly longer median times to relapse of the periorbital wrinkle for the 3‐point intramuscular injection compared with the 6‐point intradermal injection. Pain and bruising were slightly greater with the 6‐point intradermal technique.ConclusionsThis study reaffirmed the efficacy of incobotulinumtoxinA for the treatment of crow’s feet. The 3‐point intramuscular injection technique yielded greater efficacy and longer duration of action than the 6‐point intradermal injection technique.

Incobotulinum toxin A: A shelf‐stable, low‐molecular‐weight formulation

“…20 Significant reductions in the indentation of lateral periorbital lines were found with INCO. 21 Platysmal bands were successfully smoothed with 86.3% of maximal effect persisting on Day 84 of treatment. 22 F I G U R E 2 Molecular structure of incobotulinum toxin A, including the heavy chain and light chain components, from Choudhury et al 1 HC, heavy-chain C-terminal; HN, heavy-chain N-terminal.…”

“…A single‐center study injected INCO to improve facial skin laxity, sebum secretion, and facial pores throughout the face with improvements sustained through 12 weeks 20 . Significant reductions in the indentation of lateral periorbital lines were found with INCO 21 . Platysmal bands were successfully smoothed with 86.3% of maximal effect persisting on Day 84 of treatment 22…”

Evidence-Based Medicine for Nonsurgical Facial Rejuvenation

“…The study asserts that the 3-point technique resulted in a significantly greater reduction in the indentation index of periorbital wrinkles. 10 Also assessed are methods for minimizing discomfort during neuromodulator administration. In 2015, Alam et al performed a randomized clinical trial (level 2 evidence) to study the effect of needle size on 20 patients' pain perception when undergoing botulinum type A injections.…”

Tratamento complementar de rugas periorbitais com sugestão de reconstituição de toxina botulínica intradérmica

“…As rugas periorbitais que se estendem para além dos limites do músculo orbicular do olho são de difícil tratamento, pois a anatomia da região envolve músculos responsáveis pelo sorriso, e, por isso, é importante que se tenha um tratamento seguro e eficaz [4][5][6][7][8][9][10][11][12][13][14][15][16][17] .…”