Skip to main content
Top

28-03-2024 | Skin Wrinkling | ORIGINAL ARTICLE

Comparison of Wrinkle Patterns Generated by Intradermal and Intramuscular Botulinum Toxin Injections by Clinical Evaluation

Authors: Rituparna Mitra, V. B. Krishna Kumar Raja, Elavenil Panneerselvam

Published in: Journal of Maxillofacial and Oral Surgery

Login to get access

Abstract

Purpose

Botulinum toxin has played a remarkable role in management of forehead wrinkles. Most used is intramuscular technique due to its deposition into the muscles, however, with adverse effects like brow ptosis. This study has been designed for the evaluation of efficacy for intradermal v/s intramuscular route of botulinum toxin injections for forehead wrinkles using clinical correlation.

Methods

This study included a clinical trial of 32 facial halves divided equally into intradermal and intramuscular injection technique groups, receiving total dose of 8 U. Results were assessed by clinical examination upto 2 weeks and 4 weeks with parameters; objective wrinkle rate, eyebrow height, eyebrow movement, pain, and satisfaction after treatment.

Result

Results showed least mean for objective wrinkle rate in intramuscular group, showing statistically significant improvement. Overall improvement in eyebrow height and eyebrow movement were slightly more for intramuscular group. Pain was lesser for intradermal group, whereas satisfaction of patient of patient post treatment is similar for both the groups.

Conclusion

Among intradermal and intramuscular botulinum toxin injection technique, the effect and potency were better for intramuscular technique, whereas the patient comfort and compliance were better for intradermal technique.
Literature
1.
go back to reference Manríquez JJ, Cataldo K, Vera-Kellet C, Harz-Fresno I (2014) Wrinkles. BMJ Clin Evid 22(2014):1711 Manríquez JJ, Cataldo K, Vera-Kellet C, Harz-Fresno I (2014) Wrinkles. BMJ Clin Evid 22(2014):1711
2.
go back to reference Satriyasa BK (2019) Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clin Cosmet Investig Dermatol 10(12):223–228CrossRef Satriyasa BK (2019) Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clin Cosmet Investig Dermatol 10(12):223–228CrossRef
3.
go back to reference Jun JY, Park JH, Yoon CS, Lee JH (2018) Intradermal injection of botulinum toxin: a safer treatment modality for forehead wrinkles. Ann Dermatol 30(4):458–461CrossRefPubMedPubMedCentral Jun JY, Park JH, Yoon CS, Lee JH (2018) Intradermal injection of botulinum toxin: a safer treatment modality for forehead wrinkles. Ann Dermatol 30(4):458–461CrossRefPubMedPubMedCentral
4.
go back to reference Kim YJ, Lim OK, Choi WJ (2020) Are there differences between intradermal and intramuscular injections of botulinum toxin on the forehead? Dermatol Surg 46(12):e126–e131CrossRefPubMed Kim YJ, Lim OK, Choi WJ (2020) Are there differences between intradermal and intramuscular injections of botulinum toxin on the forehead? Dermatol Surg 46(12):e126–e131CrossRefPubMed
5.
go back to reference Cula GO, Bargo PR, Nkengne A, Kollias N (2013) Assessing facial wrinkles: automatic detection and quantification. Skin Res Technol 19(1):e243–e251CrossRefPubMed Cula GO, Bargo PR, Nkengne A, Kollias N (2013) Assessing facial wrinkles: automatic detection and quantification. Skin Res Technol 19(1):e243–e251CrossRefPubMed
6.
go back to reference Cartwright MJ, Kurumety UR, Nelson CC, Frueh BR, Musch DC (1994) Measurements of upper eyelid and eyebrow dimensions in healthy white individuals. Am J Ophthalmol 117(2):231–234CrossRefPubMed Cartwright MJ, Kurumety UR, Nelson CC, Frueh BR, Musch DC (1994) Measurements of upper eyelid and eyebrow dimensions in healthy white individuals. Am J Ophthalmol 117(2):231–234CrossRefPubMed
7.
go back to reference Jabbour S, Kechichian E, Nasr M (2019) Reply: the impact of upper face botulinum toxin injections on eyebrow height and forehead lines: a randomized controlled trial and an algorithmic approach to forehead injection. Plast Recon Surg 144:510e-e511CrossRef Jabbour S, Kechichian E, Nasr M (2019) Reply: the impact of upper face botulinum toxin injections on eyebrow height and forehead lines: a randomized controlled trial and an algorithmic approach to forehead injection. Plast Recon Surg 144:510e-e511CrossRef
8.
go back to reference Carruthers A, Carruthers J (2007) Eyebrow height after botulinum toxin type A to the glabella. Dermatol Surg. 33(1 spec no):S26-31CrossRefPubMed Carruthers A, Carruthers J (2007) Eyebrow height after botulinum toxin type A to the glabella. Dermatol Surg. 33(1 spec no):S26-31CrossRefPubMed
9.
go back to reference Cox SE, Finn JC, Stetler L, Mackowiak J, Kowalski JW (2003) Development of the facial lines treatment satisfaction questionnaire and initial results for botulinum toxin type A-treated patients. Dermatol Surg 29(5):444–9CrossRefPubMed Cox SE, Finn JC, Stetler L, Mackowiak J, Kowalski JW (2003) Development of the facial lines treatment satisfaction questionnaire and initial results for botulinum toxin type A-treated patients. Dermatol Surg 29(5):444–9CrossRefPubMed
10.
go back to reference Stotland MA, Kowalski JW, Ray BB (2007) Patient-reported benefit and satisfaction with botulinum toxin type A treatment of moderate to severe glabellar rhytides: results from a prospective open-label study. Plast Reconstr Surg 120(5):1386–1393CrossRefPubMed Stotland MA, Kowalski JW, Ray BB (2007) Patient-reported benefit and satisfaction with botulinum toxin type A treatment of moderate to severe glabellar rhytides: results from a prospective open-label study. Plast Reconstr Surg 120(5):1386–1393CrossRefPubMed
11.
go back to reference Cotofana S, Fratila AA, Schenck TL, Redka-Swoboda W, Zilinsky I, Pavicic T (2016) The anatomy of the aging face: a review. Facial Plast Surg 32(3):253–260CrossRefPubMed Cotofana S, Fratila AA, Schenck TL, Redka-Swoboda W, Zilinsky I, Pavicic T (2016) The anatomy of the aging face: a review. Facial Plast Surg 32(3):253–260CrossRefPubMed
12.
go back to reference Gart MS, Gutowski KA (2016) Overview of botulinum toxins for aesthetic uses. Clin Plast Surg 43(3):459–471CrossRefPubMed Gart MS, Gutowski KA (2016) Overview of botulinum toxins for aesthetic uses. Clin Plast Surg 43(3):459–471CrossRefPubMed
13.
go back to reference Majid OW (2010) Clinical use of botulinum toxins in oral and maxillofacial surgery. Int J Oral Maxillofac Surg 39(3):197–207CrossRefPubMed Majid OW (2010) Clinical use of botulinum toxins in oral and maxillofacial surgery. Int J Oral Maxillofac Surg 39(3):197–207CrossRefPubMed
14.
go back to reference Petchngaovilai C (2009) Midface lifting with botulinum toxin: intradermal technique. J Cosmet Dermatol 8:312–316CrossRefPubMed Petchngaovilai C (2009) Midface lifting with botulinum toxin: intradermal technique. J Cosmet Dermatol 8:312–316CrossRefPubMed
15.
go back to reference Trindade de Almeida AR, Marques E, de Almeida J, Cunha T et al (2007) Pilot study comparing the diffusion of two formulations of botulinum toxin type A in patients with forehead hyperhidrosis. Dermatol Surg 33:S37–S43CrossRefPubMed Trindade de Almeida AR, Marques E, de Almeida J, Cunha T et al (2007) Pilot study comparing the diffusion of two formulations of botulinum toxin type A in patients with forehead hyperhidrosis. Dermatol Surg 33:S37–S43CrossRefPubMed
16.
go back to reference Gordin EA, Luginbuhl AL, Ortlip T, Heffelfinger RN, Krein H (2014) Subcutaneous vs intramuscular botulinum toxin: split-face randomized study. JAMA Facial Plast Surg. 16(3):193–8CrossRefPubMed Gordin EA, Luginbuhl AL, Ortlip T, Heffelfinger RN, Krein H (2014) Subcutaneous vs intramuscular botulinum toxin: split-face randomized study. JAMA Facial Plast Surg. 16(3):193–8CrossRefPubMed
17.
go back to reference Kapoor R, Shome D, Jain V, Dikshit R (2010) Facial rejuvenation after intradermal botulinum toxin: is it really the botulinum toxin or is it the pricks? Dermatol Surg 36(Suppl 4):2098–2105CrossRefPubMed Kapoor R, Shome D, Jain V, Dikshit R (2010) Facial rejuvenation after intradermal botulinum toxin: is it really the botulinum toxin or is it the pricks? Dermatol Surg 36(Suppl 4):2098–2105CrossRefPubMed
18.
19.
go back to reference Sapra P, Demay S, Sapra S, Khanna J, Mraud K, Bonadonna J (2017) A single-blind, split-face, randomized, pilot study comparing the effects of intradermal and intramuscular injection of two commercially available botulinum toxin a formulas to reduce signs of facial aging. J Clin Aesthet Dermatol 10:34–44PubMedPubMedCentral Sapra P, Demay S, Sapra S, Khanna J, Mraud K, Bonadonna J (2017) A single-blind, split-face, randomized, pilot study comparing the effects of intradermal and intramuscular injection of two commercially available botulinum toxin a formulas to reduce signs of facial aging. J Clin Aesthet Dermatol 10:34–44PubMedPubMedCentral
20.
go back to reference Lee SK (2012) Multiple intradermal small bolus injection of botulinum toxin: the limit and the potentiality. J Cosmet Laser Ther 14:304–306CrossRefPubMed Lee SK (2012) Multiple intradermal small bolus injection of botulinum toxin: the limit and the potentiality. J Cosmet Laser Ther 14:304–306CrossRefPubMed
21.
go back to reference Chang SP, Tsai HH, Chen WY, Lee WR, Chen PL, Tsai TH (2008) The wrinkles soothing effect on the middle and lower face by intradermal injection of botulinum toxin type A. Int J Dermatol 47:1287–1294CrossRefPubMed Chang SP, Tsai HH, Chen WY, Lee WR, Chen PL, Tsai TH (2008) The wrinkles soothing effect on the middle and lower face by intradermal injection of botulinum toxin type A. Int J Dermatol 47:1287–1294CrossRefPubMed
Metadata
Title
Comparison of Wrinkle Patterns Generated by Intradermal and Intramuscular Botulinum Toxin Injections by Clinical Evaluation
Authors
Rituparna Mitra
V. B. Krishna Kumar Raja
Elavenil Panneerselvam
Publication date
28-03-2024
Publisher
Springer India
Published in
Journal of Maxillofacial and Oral Surgery
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI
https://doi.org/10.1007/s12663-024-02141-4