Injection Points of Botulinum Toxin
17 detachable coloured sheets
Size: 41×29,5 cm
Printed onto Tintoretto paper
Web page dedicated with extra video
Officina Editoriale Oltrarno © 2018
XVII Tablas anatómicas a color, con puntos de inyección de toxina botulínica (profundidad de inyección: intradérmica, subdérmica e intramuscular) para el tercio superior e inferior de la cara.
Tablas impresas en papel Tintoretto, realizadas gracias a la supervisión científica de MD Salvatore Piero Fundarò.
TABLA I – Músculo frontal
TABLA II – Músculo corrugador de las cejas y prócer
TABLA III – Músculo orbicular del ojo
TABLA IV – Músculos del tercio superior de la cara
TABLA V – Músculo elevador del labio superior y del ala de la nariz, músculo prócer
TABLA VI – Elevador del labio superior y del ala de la nariz y músculo elevator labio superior
TABLA VII – Músculos Depresor Septi y músculo elevator labio superior y del ala de la nariz
TABLA VIII – Músculo Depresor Anguli Oris
TABLA IX – Músculo de Mentalis
TABLA X – Músculo Orbicular de la boca
TABLA XI – Músculo de Platisma
TABLA XII – Músculo de Platisma
TABLA XIII – Músculo de Platisma
TABLA XIV – Músculo Masetero
TABLA XV – Músculos de la Tercera parte de la cara
TABLA XVI – Técnica BontLift. Tratamiento completo de la cara: Fase I
TABLA XVII – Técnica BontLift. Tratamiento completo de la cara: Fase II
|Dimensions||41 x 29.5 cm|
The purpose of this short publication is to supply an easily consulted handbook on the principle injection techniques of botulinum toxin in the main anatomic districts of the face. Precisely for its extreme conciseness there is no pretense of being an exhaustive treatment of the wide and complex subject of the aesthetic use of botulinum toxin. For further information we suggest consulting more thorough texts.
With the tables and brief annotations found in this text it is possible to verify with great speed the main skin injection points as well as the underlying anatomical muscle reference. The possibility of correlating the skin reference and the muscle injection point allows a rapid visualization of which zone of the muscle is treated and to thus understand the functional implications of each individual injection.
In fact, it is always important to remember that in the final target of botulinum toxin there are motor end plates of the facial mimetic muscles that are inhibited following the block of the release of acetylcholine in the post- synaptic space. This determines the partial or total elimination of contraction of the facial muscle fibers. Based on these premises, it is evident that determining the skin reference points is an intrinsic part of of knowledge of the topographical and functional anatomy of the mimetic muscles.
Treatment of the various facial muscles calls for inoculation at different anatomical levels depending on the site, the relationship with the overlying skin and the entity of the desired final effect. To indicate the injection depth (dermal, subdermal, intramuscular) different colors are used in order to quickly understand this aspect, which is essential for correct administration of the botulinum toxin.
The dosages indicated per individual injection or for the treatment of the entire mimetic muscle indicate an interval of variable units based on the anatomical and mimetic characteristics of each patient. It will therefore always be necessary to make a careful evaluation of the patient in order to determine what dosage is the most suited for the aesthetic outcome we wish to achieve.
In the final part there are two tables dedicated to the BontLift technique which consists in a global treatment of the face with a combination of the standard techniques and the microbotox technique (also known as intradermal mesobotox). This new method requires a more detailed explanation since it is more articulated than the individual standard techniques.
It involves two phases to be applied in the same session.
Phase I consists in the treatment of the corrugator muscles of the eyebrow, the procerus and the orbicularis oculi muscles with the standard techniques of dosages and injection depth described in the tables. In this phase the dilution used is 1.25ml per 50U Ona/Inco or 125U Abo.
Phase II, instead, involves the use of the intradermal injection technique, also known as microbotox, using a double dilution compared to that used in phase I. The dilution solution consists of 1ml of saline solution + 0.25ml of lidocaine 1% + adrenaline 1:100,000. The injection method is a fundamental aspect of the method. The depth must be intradermal in the mid or deep dermis and no more than 0.5 units must be injected per point.
Thus, using a double dilution and the intradermal
injection technique the glabella, external periocular area and the forehead will be treated, as described in the table where we can also find the correct dosage for each area.
Treatment of the upper third of the face with this double method causes a total or partial block of the muscle contractions of the upper third that is particularly effective, guaranteeing a natural effect and achieving a good balance of the depressor and elevator muscle groups of the eyebrows.
An improvement in the skin quality is also achieved thanks to the biostimulating capacity of botulinum toxin and thanks to the reduction of the sebaceous secretions which are particularly evident in patients with oily skin.
We then move on to treatment of the lower third of the face and the neck, again using the technique of intradermal microbotulin with double dilution in the area described in the table. The dosage used for the entire area is 25U Ona/ Inco or 62.5U Abo per side. The treatment of this zone of the face and neck has the purpose of reducing the action of the platysmal muscle of traction downwards on the soft tissues of the lower third of the face and the jawline. Moreover, treatment with the microbotulin technique is able to determine a certain degree of skin contraction of the neck, again following the reduction of sebaceous secretions and of the biostimulating capacity.
This provokes a lifting action on the neck and the lower third of the face.
The BontLift technique for overall treatment of the face thus calls for a total use of 100U Ona/Inco and 250U Abo distributed half on the upper third of the face and the other half on the lower third and the neck.
Salvatore Piero Fundarò MD
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