Temporal volume increase after reduction of masseteric hypertrophy utilizing incobotulinumtoxin type A

Abstract

Background:Treating the lower face with neuromodulators and targeting the masseter muscle can reduce masseteric hypertrophy but can also change the facial shape.A novel observation after the treatment of the masseter muscle with incobotulinumtoxin Type A was the increase in temporal volume. Aim:Objectively assess temporal volume increase following treatment of masseteric hypertrophy using incobotulinumtoxin Type A.Methods: Nine female patients with a mean age of 35.11 years ± 9.1 [Asian (11.1%) and Caucasian (88.9%)] were treated with incobotulinumtoxin Type A for masseteric hypertrophy. Masseteric prominence and temporal volume were assessed by two independent raters, and temporal fossa volume was measured via 3-dimensional volumetric imaging.Results: Independent of the neuromodulator injection technique (ie, single-injection versus multi-injection), a reduction in masseteric hypertrophy occurred represented by a decrease in the masseter prominence scale. In addition, the treatment resulted in a significant improvement of the temporal volume scale and an increase in the measured volume of the temporal fossa. None of the presented measurements were statistically significantly different between the two utilized injection techniques. Conclusions:This study supports using a full-face approach when performing aesthetic treatments. Anatomical concepts can help to guide treatments: the compensatory increase in temporalis function after masseter muscle treatment resulted in an increased in temporal fossa volume. The findings presented herein should not be considered as a new concept for treating the temporal fossa but rather as an additional possibility for increasing the temporal volume. K E Y W O R D S facial anatomy, incobotulinumtoxin type A, masseteric hypertrophy, neuromodulator, temporal hollowing, temporal volume | 1295 NIKOLIS et aL.

Tips and Tricks for Facial Toxin Injections with Illustrated Anatomy

“…It is of additional importance to note that treating the masseter muscle with neuromodulators will result in a compensatory volume increase of the temporalis muscle. 31 This will reduce temporal hollowing and can also be used to reshape the facial appearance. The amount of neuromodulator administered should be tailored to the muscle volume, sex, and ethnicity of the patient, which have been suggested to range between 8 and 10 IU per injection point in the Asian population, if the three-point injection technique is performed.…”

Efficacy of botulinum toxin in masseter muscle hypertrophy for lower face contouring

“…20 MMH treatment may at times lead to temporal fossa volume increase, which may be secondary to masseter paralysis or a transient bulge in the muscle, which may be secondary to minor bleeding. 36,37…”

Volumization of the young and the old temple using a highly cross‐linked HA filler

“…Historically, soft‐tissue fillers have been used to ameliorate the signs of aging by targeting folds and creases, while recent developments have shown that not only signs of aging, but rather a combination of age‐ameliorating and face‐contouring treatments can be performed 9 . A sign of aging in the upper face is temporal hollowing, which is especially visible in thin patients 10‐12 . A plethora of age‐related changes contribute to hollowing of the temples, as bone remodeling, atrophy of the temporalis muscle, thinning of the skin, and deflation of the subcutaneous and deep temporal fat create the appearance of a skeletonized face 13‐15 .…”

“…9 A sign of aging in the upper face is temporal hollowing, which is especially visible in thin patients. [10][11][12] A plethora of age-related changes contribute to hollowing of the temples, as bone remodeling, atrophy of the temporalis muscle, thinning of the skin, and deflation of the subcutaneous and deep temporal fat create the appearance of a skeletonized face. [13][14][15] Previous studies have established a relationship between facial skeletonization, temporal hollowing, and postmenopausal sarcopenia.…”