with fixed predetermined doses using a 31G needle (Figure 1). This protocol included injection points that mainly targeted the platysma, DAO, and mentalis muscle, as well as sebaceous glands and enlarged pores in the anterior medial cheek. The midglabella area and chin area (1 cm above pogonion) were also injected intramuscularly and intradermally (2.5 U each) with a total of 5 U for sebum measuring points. In total, the patient was injected 92 U of INCO using the microdroplet technique.19,20
Assessments of Facial Lifting, Sebum Control, and Facial Pores
The clinical outcome was evaluated at baseline and each follow-up visit. Sebum production was measured using a Sebumeter (SM815; Courage and Khazaka, Cologne, Germany) on the forehead and chin as previously described,21,22 over the same area where INCO was injected. Mandibular length and facial pore (count and density) were evaluated using a three-dimensional scanner (Morpheus 3D; Morpheus Co., Gyeonggi, South Korea).23-25 This device contained software that automatically analyzed three-dimensional facial images, including measurement of mandibular length and facial pores. The mandibular length was calculated as the lowest border of soft tissue from one side of the gonion via gnathion to the opposite side of gonion (Figure 2). Facial pores were counted on both cheeks, where INCO was injected (Figure 3).
A facial laxity rating (FLR) scale of the lower face was evaluated by an investigator (J.Y. Park) based on photography. The FLR scale graded the laxity of the face from no laxity (class 0) to severe laxity (class 9), including the upper face, middle face, lower face, and neck.26 Additionally, the Global Aesthetic Improvement Scale (GAIS) was scored by the investigator (Investigator’s GAIS, IGAIS) and each patient (Subject’s GAIS, SGAIS), which was scored as follows; 4; very much improved, 3; much improved, 2; improved, 1; no change, 0; worsened.
Assessments of Facial Lifting, Sebum Control, and Facial Pores
The clinical outcome was evaluated at baseline and each follow-up visit. Sebum production was measured using a Sebumeter (SM815; Courage and Khazaka, Cologne, Germany) on the forehead and chin as previously described,21,22 over the same area where INCO was injected. Mandibular length and facial pore (count and density) were evaluated using a three-dimensional scanner (Morpheus 3D; Morpheus Co., Gyeonggi, South Korea).23-25 This device contained software that automatically analyzed three-dimensional facial images, including measurement of mandibular length and facial pores. The mandibular length was calculated as the lowest border of soft tissue from one side of the gonion via gnathion to the opposite side of gonion (Figure 2). Facial pores were counted on both cheeks, where INCO was injected (Figure 3).
A facial laxity rating (FLR) scale of the lower face was evaluated by an investigator (J.Y. Park) based on photography. The FLR scale graded the laxity of the face from no laxity (class 0) to severe laxity (class 9), including the upper face, middle face, lower face, and neck.26 Additionally, the Global Aesthetic Improvement Scale (GAIS) was scored by the investigator (Investigator’s GAIS, IGAIS) and each patient (Subject’s GAIS, SGAIS), which was scored as follows; 4; very much improved, 3; much improved, 2; improved, 1; no change, 0; worsened.
