Achraf ELLOUADGHIRI EL IDRISSI 医师
皮肤科医师
Glabella tretament with neuromodulators: the 5-point injection vs the 3-point injection technique
Objectives: Tje aim of this study was to investigate the safety and efficacy profile of the 3-point injection technique and compare it to the 5-point injection technique.
Introduction: Glabella lines treatment with neuromodulators relies on a 5-point injection technique which is by far the most popular pattern for this area. Most feared side effects when using botulinum toxin in the glabella region are brow and eyelid ptosis. These side effects might be caused by a non controlled injection of the corrugators in the lateral point chasing the muscle on his length. The recently proposed 3-point injection technique is alleged to be safer and with same results.
Materials / method: Our study included 53 patients treated with botulinum toxin A for glabella lines. Patients were divided into 3 groups : first group was treated using the 5-point injection technique, second group using the 3-point injection technique and the third group with split face design using the 5-point injection on one side and the 3-point inejction technique on the controlateral side (using the same total of units on each side). Careful analyse using standardized photos and videos were used to assess the static and dynamic results of both the two techniques before and 14 days after the treatment.
Results: No significant difference between the two techniques in term of safety was noted but this conclusion is limited by the number of patients included. Though there is no absolute superiority of one technique to the other on the efficacy profile, the results were more interesting to analyse in a qualitative way as there were significant differences in the results obtained, regarding the anatomical variant of the corrugators (shape, length and distribution of the strength of the muscle), the natural aspect desired (or not) by the patient and the experience of the injector.
Conclusion: In our experience, the 3-point injection technique appears to be a safe and efficient option for the treatment of glabella frown lines especially for novice injectors, medium strength corrugators and when patients claim residual movement after treatment ; but this technique can show lack of efficacy in some anatomical variants of the corrugators described in this study or when the natural effect is not needed. A simplified algorithm is proposed to help practitionners integrate this technique in their daily practice.
