摘要

Objectives: The topic of my presentation is how to detect, recognize and treat accurately the asymmetries of the upper thirth superior of the face, related to the hypertonicity of mimic muscles. I will present how to get images correctly by three-dimensional imaging, static and dynamic anatomy, showing my clinicaI cases. The purpose is to led to a correct diagnosis of the muscle (s) affected by hypertonicity (elevator, depressors or both) and to apply a tailored treatment plan with botuline toxinA (Bont-A). Introduction: Significant asymmetries in the upper third of the face can affect beauty, attractiveness and perceptions. The analysis of the muscle of upper superior at rest and in dynamic is strongly recommended to plan proper point dose and full dose treatment with Bont-A. Asymmetries of the upper thirth superior related to the hypertonicity of elevator, or medial and lateral depressors are very common. These asymmetries can manifest in various forms, such as brow height, brow shape and differences in eye size but can also can influence emotional perception and percevied harmony. Materials / method: A clinical series since 2021, belonging to my personal activity, will be presented by 3D immages at rest, in dynamic before and after the treatment with Bont-A. Each case will be representative of different altered muscle patterns involving elevator and depressors: a detailed and persolizated treatment plan will be presented. In particular the asimmetry of the brow will be analyzed in detail in each part (lateral, medial, whoole) as well as the orbicularis. The treatment plan and the results of tailored treatment will be showed. Results: Asymmetries related to the hypertonicity of elevator muscle are often succesfully treated with Bont-A Asymmetries of medial depressors are more difficult to solve than lateral depressor. Conclusion: Assessment techniques as clinical examination, photographic analysis, 3 D imaging are necessary tools before the treatment with Bont-A. Tailored treatment is compulsory in documented asymmetries of mimic muscles of the thirth superior of the face.