Abstract
Objective
To establish botulinum toxin-A (BTX-A) rejuvenation as an innovative technique to treat facial sagging with descent of the mid and lower face in Asian females.
Methods
Between March 2016 and March 2017, 512 female patients with facial sagging were treated with regional platysma BTX-A injection. Droplet injection into the dermis was performed. Among the patients, 192 were recruited into our retrospective study. Eligible patients were divided into a pre-senile group (28–39 years old) and a senile group (> 40 years old). We analyzed the patient/physician-graded improvement, the mean scores of the 5-point improvement scale, and any reported complications.
Results
The overall degree of both patient- and physician-graded mid-face aesthetic improvement was very high. Improvement ratings reached 97.92% for patients and 94.79% for physicians. Improvement ratings were significantly greater in the pre-senile group compared to the senile group (p < 0.001), suggesting that the pre-senile patients were more satisfied with their improvement. Moreover, the percent of patients who reported as “much improved” was significantly higher than the percent of physicians (p < 0.05), suggesting that patients felt more positively about their aesthetic results than the physicians. No severe side effects were reported.
Conclusions
Our results demonstrated that regional BTX-A injection in the dermis for the purpose of aesthetical platysma rejuvenation is safe and effective in patients with facial sagging with descent of the mid and lower face. Specifically, regional platysma injections of BTX-A (BTX-A rejuvenation) can correct descent of the mid and lower face in Asian females, demonstrating clinical utility of this treatment strategy.
Level of Evidence V
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-019-01396-4/MediaObjects/266_2019_1396_Fig1_HTML.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-019-01396-4/MediaObjects/266_2019_1396_Fig2_HTML.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-019-01396-4/MediaObjects/266_2019_1396_Fig3_HTML.png)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-019-01396-4/MediaObjects/266_2019_1396_Fig4_HTML.png)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-019-01396-4/MediaObjects/266_2019_1396_Fig5_HTML.png)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-019-01396-4/MediaObjects/266_2019_1396_Fig6_HTML.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-019-01396-4/MediaObjects/266_2019_1396_Fig7_HTML.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs00266-019-01396-4/MediaObjects/266_2019_1396_Fig8_HTML.jpg)
Similar content being viewed by others
References
Bilwatsch S, Kramer M, Haeusler G, Schuster M, Wurm J, Vairaktaris E, Neukam FW, Nkenke E (2006) Nasolabial symmetry following Tennison-Randall lip repair: a three-dimensional approach in 10-year-old patients with unilateral clefts of lip, alveolus and palate. J Craniomaxillofac Surg 34:253–262
Castello MF, Lazzeri D, Silvestri A, Agostini T, Gigliotti D, Marcelli C, D’Aniello C, Gasparotti M (2011) Modified superficial musculoaponeurotic system face-lift: a review of 327 consecutive procedures and a patient satisfaction assessment. Aesthetic Plast Surg 35:147–155
Trindade de Almeida A, Carruthers J, Cox SE, Goldman MP, Wheeler S, Gallagher CJ (2015) Patient satisfaction and safety with aesthetic onabotulinumtoxinA after at least 5 years: a retrospective cross-sectional analysis of 4,402 glabellar treatments. Dermatol Surg 41(Suppl 1):S19–28
Bae JH, Youn KH, Hu KS, Lee JH, Tansatit T, Kim HJ (2016) Clinical implications of the extension of platysmal fibers on the middle and lower face. Plast Reconstr Surg 138:365–371
Wu WT (2015) Microbotox of the lower face and neck: evolution of a personal technique and its clinical effects. Plast Reconstr Surg 136:92S–100S
Yang NZ, Wang ZJ, Wang B, Su XW, Lu N (2012) Anatomic study of malar fat pad and aging analysis. Zhonghua Zheng **ng Wai Ke Za Zhi 28:212–217
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
The authors declare that they have no conflict of interest.
Ethical Approval
This study was approved by our institution’s ethics committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Zhou, R., Fei, Y., Sun, L. et al. BTX-A Rejuvenation: Regional Botulinum Toxin-A Injection of the Platysma in Patients with Facial Sagging. Aesth Plast Surg 43, 1044–1053 (2019). https://doi.org/10.1007/s00266-019-01396-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-019-01396-4