Master Case Presentation
Multipoint and multilevel injection technique of botulinum toxin A in facial aesthetics
Article first published online: 9 JUN 2014
© 2014 Wiley Periodicals, Inc.
Journal of Cosmetic Dermatology
Volume 13, Issue 2, pages 135–142, June 2014
How to Cite
Iozzo, I., Tengattini, V. and Antonucci, V. A. (2014), Multipoint and multilevel injection technique of botulinum toxin A in facial aesthetics. Journal of Cosmetic Dermatology, 13: 135–142. doi: 10.1111/jocd.12090
- Issue published online: 9 JUN 2014
- Article first published online: 9 JUN 2014
- Manuscript Accepted: 9 FEB 2014
- botulinum toxin A;
- multipoint and multilevel injection technique;
- Facial Line Treatment Satisfaction Questionnaire
Botulinum toxin represents one of the most frequently requested cosmetic procedures. We treated 223 patients with facial wrinkles using a new technique of injection of botulinum toxin A (BTA) called multipoint and multilevel injection technique (MMIT). The aim of MMIT was to relax the muscle and not paralyze it. Patient satisfaction was evaluated by Facial Line Treatment Satisfaction Questionnaire (FTSQ). Treatment with botulinum toxin determined a good response in all patients. Facial rhytids were completely resolved in case of young skin and well reduced in case of aged skin, leaving a natural aspect both in static and dynamic wrinkles. Patient mean overall satisfaction evaluated with FTSQ was 6.4 ± 1.1. In our experience, the use of botulin toxin by MMIT consents a better calibration of action with a soft and natural result. This can be achieved by distributing the BTA dose through various injection points for each area (“multipoint injections”). Furthermore, injections can be performed at different levels (“multilevel injections”). The level of injections regulates the potency of effect on the muscle: if the level is deep (intramuscular), the effect will be strong while if it is medium or superficial (subcutaneous and intradermal), the effect will be soft. This consents a fine calibration of action on muscle activity with a personal aesthetic result.