Use of Neuromodulators as Aesthetic Treatment in the Lower Face
Abstract
Neuromodulator treatment is one of the most common non-invasive aesthetic treatments in dermatology. Botulinum toxin A has been established as a safe and effective treatment for the upper face. It is increasingly used beyond the forehead, glabella and peri-ocular region. The purpose of lower face neuromodulator is to soften dynamic rhytids, improve facial expression at rest and with animation, and provide facial contouring. There is significant interplay between the muscles of the lower face for expression and function; therefore, careful administration of botulinum toxin A is necessary to avoid adverse effects. This article reviews off-label botulinum toxin A treatments to the peri-oral region, chin and masseter. For the purposes of the article, all dosing provided is for onabotulinum toxin A.
References
Al-Fouzan AF, Mokeem LS, Al-Saqat RT, Alfalah MA, Alharbi MA, Al-Samary AE. Botulinum Toxin for the Treatment of Gummv Smile. J Contemp Dent Pract. 2017 Jun 1;18(6):474-8.
Dinker S, Anitha A, Sorake A, Kumar K. Management of gummy smile with Botulinum Toxin Type-A: A case report. J Int Oral Health. 2014 Feb;6(1):111.
Razmaitė A, Trakinienė G. The effect of botox for the correction of the gummy smile: A systematic review. Stomatologija. 2021 Jan 1;23(3):63-8.
Harview CL, Tan KW, Dhinsa HK, Harms JL. The neurotoxin “lip flip”: A case series and discussion. J Cosmet Dermatol. Nov 2021;20(11):3716-3718.
de Maio M, Wu WTL, Goodman GJ, Monheit G, Committee AftFoAC. Facial assessment and injection guide for botulinum toxin and injectable hyaluronic acid fillers: focus on the lower face. Plast Reconstr Surg. Sep 2017;140(3):393e-404e.
Kim DH, Hong HS, Won SY, Kim HJ, Hu KS, Choi JH, Kim HJ. Intramuscular nerve distribution of the masseter muscle as a basis for botulinum toxin injection. J Craniofacial Surg. 2010 Mar 1;21(2):588-91.
Sundaram H, Huang PH, Hsu NJ, Huh CH, Wu WT, Wu Y, Cassuto D, Kerscher MJ, Seo KK, Pan-Asian Aesthetics Toxin Consensus Group. Aesthetic applications of botulinum toxin A in Asians: an international, multidisciplinary, Pan-Asian consensus. Plast Reconstr Surg Glob Open. 2016 Dec;4(12).
Sundaram H, Weinkle S, Pozner J, Dewandre L. Blunt-tipped microcannulas for the injection of soft tissue fillers: a consensus panel assessment and recommendations. J Drugs Dermatol. 2012 Aug 1;11(8):s33-9.