INTRODUCTION
Botulinumtoxin type A (BoNT-A) injections are the most popular cosmetic procedure in the world.1 By blocking acetylcholine neurotransmitter presynaptic release, this neurotoxin can reduce muscle contraction and lead to functional benefits in spasticity and cosmetic effects in minimizing wrinkles. There are several different preparations of BoNT-A available for aesthetic use worldwide, each with different manufacturing processes and properties.
AbobotulinumtoxinA (aboBoNT-A; Dysport, Ipsen Biopharm Ltd., Wrexham, UK; Azzalure, Galderma Ltd., Lausanne, Switzerland) is currently approved in the United States of America for treating moderate to severe glabellar lines associated with procerus and corrugator muscle activity in adult patients younger than 65 years of age for aesthetic purposes.2 The current US Food and Drug Administration (FDA)-recommended dosing is 50 U injected intramuscularly in 5 equal aliquots of 10 U each using a reconstitution involving 2.5 mL saline added to a 300 U vial. A reconstitution involving 1.5 mL saline added to a 300 U vial is also used on-label.
Several total face rejuvenation studies have included treating the platysma with aboBoNT-A, using doses ranging from 40 U to 180 U and concentrations of 10 U to 12 U per 0.1 mL.4-8 A study by Jabbour et al evaluated the "Nefertiti Lift," which focused on injecting aboBoNT-A into platysmal bands and along a line below the inferior mandibular border.9 Each injection involved 5 U of aboBoNT-A, which had been reconstituted to a concentration of 20 U per 0.1 mL. The maximum dose allowed was 125 U and the mean dose used was 114.3 U. A touch-up treatment was performed using the same protocol for any
AbobotulinumtoxinA (aboBoNT-A; Dysport, Ipsen Biopharm Ltd., Wrexham, UK; Azzalure, Galderma Ltd., Lausanne, Switzerland) is currently approved in the United States of America for treating moderate to severe glabellar lines associated with procerus and corrugator muscle activity in adult patients younger than 65 years of age for aesthetic purposes.2 The current US Food and Drug Administration (FDA)-recommended dosing is 50 U injected intramuscularly in 5 equal aliquots of 10 U each using a reconstitution involving 2.5 mL saline added to a 300 U vial. A reconstitution involving 1.5 mL saline added to a 300 U vial is also used on-label.
aboBoNT-A is commonly used to treat wrinkles and lines in other areas of the face, neck, and chest for cosmetic purposes in an off-label manner.3 One area of increasing interest is treating the platysma as an effective non-surgical option for reducing platysmal bands and for improving jawline and neck contour. Treatment of the platysma with onabotulinumtoxinA (onaBoNT-A; Botox, Allergan, Irvine, CA, USA) has been well studied, and the mean dose for injection typically ranges between 10 U and 50 U.4
Several total face rejuvenation studies have included treating the platysma with aboBoNT-A, using doses ranging from 40 U to 180 U and concentrations of 10 U to 12 U per 0.1 mL.4-8 A study by Jabbour et al evaluated the "Nefertiti Lift," which focused on injecting aboBoNT-A into platysmal bands and along a line below the inferior mandibular border.9 Each injection involved 5 U of aboBoNT-A, which had been reconstituted to a concentration of 20 U per 0.1 mL. The maximum dose allowed was 125 U and the mean dose used was 114.3 U. A touch-up treatment was performed using the same protocol for any
