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Objectives: Cadaver dissections show where dyed fillers are positioned when injected in or under the origin of the mentalis muscles or under the frontalis muscles, before and after remodeling by firm finger pressure. Representative clinical photography suggests how to put this into aesthetic practice for myomodulation of mentalis or frontalis muscle activity respectively.

Introduction: It has been postulated that changing the course of facial muscles by the injection of fillers can influence muscle function by changing their preload. In case less muscle tone is required to reach the same effect of muscle action, a decrease of muscle tone may reduce certain dynamic wrinkles. In case muscle action is not altered, its clinical effect is supposed to increase.

Materials / method: Dyed agarose was injected with a 25G cannula under frontalis muscles and with a 27 G needle as deep as possible in or under the origin of mentalis muscles in cadaver dissections, to verify the position of fillers after intentional injection as deep as possible. Representative before and after clinical photography of filler injections in the chin and in the forehead were studied to document the effect on chin frowning and eyebrow elevation respectively.

Results: The large majority of filler injected below the frontalis muscles is found in that location in cadaver dissections, although intramuscular position becomes more likely at larger distances from a cannula entrance point. Filler injected deep on the chin is located under the junction of both mentalis muscles or deep in the muscle bodies.
Subfrontalis filler injection can at times raise the eyebrows, reduce forehead wrinkles or both. Deep filler injection on the chin can be a more long-lasting treatment of chin frowning than muscle weakening with botulinum toxin.

Conclusion: There are clinical indications that the function of the mentalis muscle in mouth closure in patients with mild retrogenia can be improved by deep injection of filler, leading to a decrease of resting and active tone and of chin skin "frowning". In some patients, injection under the frontalis muscles leads to decreased muscle tone and forehead wrinkles with the eyebrows in the same position, in others a mild extra lift is observed. This effect can be put to the patient's advantage in a holistic approach to the forehead and periorbital area.

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Objectives: Botulinum toxin injections have changed the face of cosmetic medicine and is the most common cosmetic procedure being performed world-wide today. In addition to the common injections we all perform, recent evaluations looking at both high-dose toxin injections and micro-injections have become increasingly popular in the past several years. This presentation will review the most recent data associated with the use of high-dose toxins in the treatment of glabellar furrows.

Introduction: Botulinum toxin injections have become the most popular cosmetic procedures being performed worldwide and even during the pandemic, have remained very popular for our patients. Recent investigations have studied the use of high-dose toxin injections for increased longevity of the procedure as well as microinjections of toxins for the improvement of skin, especially in regard to facial redness and sebum production. This presentation will look at some of the recent advances with high-dose toxins.

Materials / method: Through a literature review and data that is in the public domain, this presentation will look at the clinical results of using botulinum toxin in high doses for the treatment of glabellar furrows.

Results: All of the studied toxins have shown safety and efficacy in their clinical evaluations of the use of high-dose toxins in the glabellar furrows. The data from the studies that are available will be presented.

Conclusion: High-dose botulinum toxin injections are safe and effective and should be considered for patients interested in receiving longer term cosmetic outcomes as compared to "traditional" botulinum toxin injections.

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请注明名称（个人，公司，学会等等）: Merz

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这项工作的完成感谢以下机构的支持： Merz

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