Types of periocular wrinkles based on anatomical and contractile characteristics of participating periocular muscles: A modified classification method and personalized injection technique

Abstract

Background: Clinical classification methods for periocular wrinkles based on participating muscle behavior are lacking, and traditional treatment lacks detailed and individualized methods. Aims: This study aimed to propose a modified classification system and individualized treatment for periocular wrinkles based on the participating muscles. Patients/Methods: Periocular wrinkles were classified into types I.I, I.II, I.III, II, and III. A personalized treatment pattern with a multipoint, low-dose technique was developed based on wrinkle classification and severity. Standard photographs were taken and assessments made at follow-up to evaluate wrinkle severity.Results: Wrinkle severity was reduced at 1 and 3 months after periorbital botulinum toxin injection, and no serious adverse events were recorded.Conclusions: Periorbital wrinkles were classified according to participating muscles.The modified injection pattern was individualized, effective, and safe for the treatment of periorbital wrinkles.

Three-point Method Nerve Block for Relieving Pain of Microbotox Injection in Middle and Upper Face

“…Therefore, the injection scope should be properly expanded to adjust muscle balance. 13 To improve the therapeutic effect, some experts proposed the microbotox technique, which increases the number of injection sites and reduces the injection dosage at each site. [14][15][16] Multiple microdroplet injections can achieve uniform drug injection, personalized drug distribution, and more accurate and natural effects.…”

“…Intradermal injection can also reduce the sebaceous and sweat gland secretions, shrink pores, relax the surface fibers of facial muscles more effectively, and reduce fine wrinkles as well. 13 , 14 To improve the wrinkle removal effect of botulinum toxin, we adopted multi-point and microdrop injection combined with partial point intradermal injection 12 ; this technique increases the pain and discomfort during the treatment process, which urged us to improve the facial nerve block technique (Fig. 5 ).…”

“…[14][15][16] Multiple microdroplet injections can achieve uniform drug injection, personalized drug distribution, and more accurate and natural effects. Han et al 13 recommended that botulinum toxin injections should be administered in the dermis for periocular wrinkles to control drug dispersion and reduce injection difficulty. Intradermal injection can also reduce the sebaceous and sweat gland secretions, shrink pores, relax the surface fibers of facial muscles more effectively, and reduce fine wrinkles as well.…”

The impact of SARS-Cov-2 infection on the periocular injection pain and hypersensitive reaction to botulinum toxin type A: results from clinical questionnaires

“…The botulinum toxin brand used in this study was BTA (Botox; Allergan, Inc.), leaving no opportunity to study other brands. While the injections were performed by the same physician who had administered BTA several times before, individual injection methods varied due to differences in wrinkles presented by each patient, introducing a variable that could not be completely controlled ( Li et al., 2022 ). Additionally, as the patients were only undergoing outpatient injection treatments, no blood analysis of inflammation and allergy factors was conducted to better analyze the correlation between pain and allergies.…”