The wrinkles soothing effect on the middle and lower face by intradermal injection of botulinum toxin type A

Authors:
  • HTHsiou‐Hsin Tsai
    Hsiou‐Hsin Tsai
  • WCWei‐Yu Chen
    Wei‐Yu Chen
  • WLWoan‐Ruoh Lee
    Woan‐Ruoh Lee
  • PCPing‐Ling Chen
    Ping‐Ling Chen
  • TTTsung‐Hsien Tsai
    Tsung‐Hsien Tsai
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Abstract
Background  Botulinum toxin type A (BTA) has been used on facial expressive muscles to reduce wrinkles. We assumed that intradermal injection with BTA on the middle and lower face can produce face‐lifting and wrinkles‐soothing effect by promoting collagen synthesis.Methods  Nine volunteers were included to undergo intradermal injections of a total dose of 20~25 U BTA into one‐half of the face, and normal saline into the other half as control. Clinical photographs were taken every 4 weeks for 16 weeks, and evaluated by a doctor blinded to the assignments. Patients graded the results of wrinkles elimination on each follow‐up. Skin biopsies were taken before the treatment and 8 weeks after the injection. The specimens were assessed by a pathologist using hematoxylin and eosin stain, elastin stain, Masson trichrome stain and immunohistochemical stain with type I procollagen.Results  By photographic documentation, there was no significant face‐lifting effect. However, there was statistical significance in wrinkles reduction on the BTA sides compared to pre‐treatment. Subjectively, six subjects noticed better wrinkles soothing effect on the BTA sides. This effect was noted as early as 4 weeks after injection, and lasted for a minimum 8 weeks. The histologic examination revealed slight neocollagen synthesis by Masson trichrome stain on both sides.Conclusions  Based on this pilot study, the face‐lifting effect of intradermal injection with BTA was not conclusive. Interestingly, BTA showed moderate but significant wrinkles‐soothing effect without obvious side effects on the lower face.

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