Consensus recommendations on the aesthetic usage of botulinum toxin type A in Asians

Dermatol Surg. 2013 Dec;39(12):1843-60. doi: 10.1111/dsu.12317. Epub 2013 Oct 11.

Abstract

Background: The use of botulinum toxin has rapidly expanded into various aesthetic applications. Any guideline representing a consensus for aesthetic treatments using botulinum toxin type A (BTA) in Asians has not been published.

Objectives: To provide consensus recommendations on common aesthetic problems which are treated by neurotoxin in Asians.

Methods: A panel of experienced Korean dermatologists was convened to develop a clinical consensus on common aesthetic problems involving the face, neck, and calves in Asians, based on their own extensive experience.

Results: The consensus recommendations address general questions regarding treatment and provide specific guidelines on each common aesthetic indication. The recommended final concentration of BTA was 50 U/mL after reconstitution with physiologic saline. For horizontal forehead lines, the members recommended nine injections in two rows into the frontalis with 1 U/point. For glabellar lines, the members recommended three injection points (a total of 8 U). For crow's feet, the members recommended three injections per side (7 U/side) at the lateral part of the orbicularis oculi. For infraorbital wrinkles, one to two points per side in the superficial subcutaneous space approximately 1 cm below the lash line were recommended (1-2 U/side). For nasal flare, one injection point in the middle of each ala nasi was recommended (a total of 2 U). For depressed nasal tip, a single injection deep within the columella was recommended, with a dose of 3 U. For benign masseter hypertrophy, the members recommended a six-point injection to the masseter (three points per side for a total of 50-60 U). For the treatment of calf hypertrophy, the members recommended a total dose of 100 to 120 U (50-60 U/side), divided between six injection points (approximately 8-10 U/point).

Conclusion: This guideline provides a framework for physicians who wish to perform safe and efficacious injections of BTA in Asians.

MeSH terms

  • Asian People*
  • Botulinum Toxins, Type A / therapeutic use*
  • Consensus*
  • Esthetics*
  • Face
  • Humans
  • Leg
  • Neck
  • Neuromuscular Agents / therapeutic use*
  • Republic of Korea
  • Skin Aging
  • Surveys and Questionnaires

Substances

  • Neuromuscular Agents
  • Botulinum Toxins, Type A