Relationship between Muscle Strength Pattern, Classification of Facial Wrinkles, and Dose of Botulinum Toxin Serotype A

Abstract

Introduction The primary action of botulinum toxin type A (BoNT-A) is to inhibit acetylcholine release from the presynaptic terminal, resulting in reversible chemical muscle paralysis. It is a widely accepted treatment for improving the appearance of glabellar expression lines resulting from muscle contraction.

Materials and Methods We evaluated the glabellar force patterns, facial wrinkle classification, and the number of BoNT-A units used in the corrugator and procerus muscles.

Results The mean total BoNT-A units used were 7.2 IU in the corrugator muscle (7.1 IU in women and 7.4 IU in men) and 3.9 IU in the procerus muscle (3.9 IU in women and 4.1 IU in men), with a positive correlation between the number of units and the age of the 58 participants. Regarding muscle strength pattern, more units were needed in the corrugator muscle with a strong or moderate pattern and facial wrinkle classification ranging from 3 to 4 (8 IU and 8.5 IU, respectively). The procerus muscle required more units in subjects with strong force patterns and wrinkles classified as 3 to 4 (5 IU). Wrinkles with a 3-to-5 classification required the highest number of BoNT-A units.

Conclusion The number of BoNT-A units used is directly proportional to the strength pattern and classification of facial wrinkles, with more units required for strong force patterns and deep wrinkle classifications.

Keywords

botulinum toxins, type A - dermatology - facial muscles - rosacea - skin aging

Authors' Contributions

JVMPN: data analysis and/or interpretation; final manuscript approval; funding acquisition; data collection; conceptualization; study conception and design; methodology; performance of procedures and/or experiments; writing – original draft preparation; writing – review and editing; and supervision; GDM: data analysis and/or interpretation; final manuscript approval; data collection; investigation; methodology; writing – original draft preparation; and writing – review and editing; RCC: data analysis and/or interpretation; statistical analysis; data collection; and writing – original draft preparation; MPM: data analysis and/or interpretation; statistical analysis, final manuscript approval; data collection; methodology; writing – original draft preparation; writing – review and editing; and software.

Publikationsverlauf

Eingereicht: 07. Juni 2024

Angenommen: 16. November 2024

Artikel online veröffentlicht:
13. Februar 2025

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