Nonsurgical correction of drooping mouth corners using monophasic hyaluronic acid and incobotulinumtoxinA

Gee Young Bae, Jung Im Na, Kyoung Chan Park, Sung Bin Cho

Research output: Contribution to journalArticle

Abstract

Background: Nonsurgical correction of drooping of the corners of the mouth requires a multimodal approach combining botulinum toxin and soft tissue filler injections. Objective: To validate a nonsurgical therapeutic approach for correcting a “saddened” appearance characterized by drooping mouth corners, oral commissures, and/or marionette lines. Methods: In this prospective, evaluator-blinded study, monophasic hyaluronic acid (MHA) was infiltrated to correct drooping mouth corners in four steps, deep oral commissures in two steps, and/or deep marionette lines in two steps, in that order. Then, incobotulinumtoxinA was injected along the depressor anguli oris and mentalis muscles. Results: The total volumes of MHA used in steps 1-4 were 0.2 mL (interquartile range [IQR]: 0.19-0.3) for the right side of the face and 0.25 mL (IQR: 0.2-0.3) for the left side; total volumes in steps 5-8 were 0.18 mL (IQR: 0-0.4) for the right side and 0.15 mL (IQR: 0-0.33) for the left side. The total mean dose of incobotulinumtoxinA was 26.5 units (IQR: 24-28). The median degrees of drooping of the mouth corners were −4° (IQR: −7° to −2°) at baseline, −1° (IQR: −3° to 1°) at post-treatment 2 weeks, and −1° (IQR: −3° to 0°) at post-treatment 3 months. Median Global Aesthetic Improvement Scale scores were 3 (IQR: 2-3) at post-treatment 2 weeks and 3 (IQR: 2-3.75) at 3 months. Conclusion: Our results demonstrated that nonsurgical treatment with MHA and incobotulinumtoxinA provides satisfactory therapeutic outcomes in patients with a saddened appearance by correcting drooping of the mouth corners, deep oral commissures, and/or deep marionette lines.

Original languageEnglish
Pages (from-to)338-345
Number of pages8
JournalJournal of Cosmetic Dermatology
Volume19
Issue number2
DOIs
StatePublished - 1 Feb 2020

Fingerprint

Hyaluronic Acid
Mouth
Therapeutics
Botulinum Toxins
Esthetics
incobotulinumtoxinA
Muscles
Injections

Keywords

  • cohesive polydensified matrix hyaluronic acid
  • incobotulinumtoxinA
  • marionette line
  • melomental fold
  • mouth corner
  • oral commissure

Cite this

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title = "Nonsurgical correction of drooping mouth corners using monophasic hyaluronic acid and incobotulinumtoxinA",
abstract = "Background: Nonsurgical correction of drooping of the corners of the mouth requires a multimodal approach combining botulinum toxin and soft tissue filler injections. Objective: To validate a nonsurgical therapeutic approach for correcting a “saddened” appearance characterized by drooping mouth corners, oral commissures, and/or marionette lines. Methods: In this prospective, evaluator-blinded study, monophasic hyaluronic acid (MHA) was infiltrated to correct drooping mouth corners in four steps, deep oral commissures in two steps, and/or deep marionette lines in two steps, in that order. Then, incobotulinumtoxinA was injected along the depressor anguli oris and mentalis muscles. Results: The total volumes of MHA used in steps 1-4 were 0.2 mL (interquartile range [IQR]: 0.19-0.3) for the right side of the face and 0.25 mL (IQR: 0.2-0.3) for the left side; total volumes in steps 5-8 were 0.18 mL (IQR: 0-0.4) for the right side and 0.15 mL (IQR: 0-0.33) for the left side. The total mean dose of incobotulinumtoxinA was 26.5 units (IQR: 24-28). The median degrees of drooping of the mouth corners were −4° (IQR: −7° to −2°) at baseline, −1° (IQR: −3° to 1°) at post-treatment 2 weeks, and −1° (IQR: −3° to 0°) at post-treatment 3 months. Median Global Aesthetic Improvement Scale scores were 3 (IQR: 2-3) at post-treatment 2 weeks and 3 (IQR: 2-3.75) at 3 months. Conclusion: Our results demonstrated that nonsurgical treatment with MHA and incobotulinumtoxinA provides satisfactory therapeutic outcomes in patients with a saddened appearance by correcting drooping of the mouth corners, deep oral commissures, and/or deep marionette lines.",
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Nonsurgical correction of drooping mouth corners using monophasic hyaluronic acid and incobotulinumtoxinA. / Bae, Gee Young; Na, Jung Im; Park, Kyoung Chan; Cho, Sung Bin.

In: Journal of Cosmetic Dermatology, Vol. 19, No. 2, 01.02.2020, p. 338-345.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Nonsurgical correction of drooping mouth corners using monophasic hyaluronic acid and incobotulinumtoxinA

AU - Bae, Gee Young

AU - Na, Jung Im

AU - Park, Kyoung Chan

AU - Cho, Sung Bin

PY - 2020/2/1

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N2 - Background: Nonsurgical correction of drooping of the corners of the mouth requires a multimodal approach combining botulinum toxin and soft tissue filler injections. Objective: To validate a nonsurgical therapeutic approach for correcting a “saddened” appearance characterized by drooping mouth corners, oral commissures, and/or marionette lines. Methods: In this prospective, evaluator-blinded study, monophasic hyaluronic acid (MHA) was infiltrated to correct drooping mouth corners in four steps, deep oral commissures in two steps, and/or deep marionette lines in two steps, in that order. Then, incobotulinumtoxinA was injected along the depressor anguli oris and mentalis muscles. Results: The total volumes of MHA used in steps 1-4 were 0.2 mL (interquartile range [IQR]: 0.19-0.3) for the right side of the face and 0.25 mL (IQR: 0.2-0.3) for the left side; total volumes in steps 5-8 were 0.18 mL (IQR: 0-0.4) for the right side and 0.15 mL (IQR: 0-0.33) for the left side. The total mean dose of incobotulinumtoxinA was 26.5 units (IQR: 24-28). The median degrees of drooping of the mouth corners were −4° (IQR: −7° to −2°) at baseline, −1° (IQR: −3° to 1°) at post-treatment 2 weeks, and −1° (IQR: −3° to 0°) at post-treatment 3 months. Median Global Aesthetic Improvement Scale scores were 3 (IQR: 2-3) at post-treatment 2 weeks and 3 (IQR: 2-3.75) at 3 months. Conclusion: Our results demonstrated that nonsurgical treatment with MHA and incobotulinumtoxinA provides satisfactory therapeutic outcomes in patients with a saddened appearance by correcting drooping of the mouth corners, deep oral commissures, and/or deep marionette lines.

AB - Background: Nonsurgical correction of drooping of the corners of the mouth requires a multimodal approach combining botulinum toxin and soft tissue filler injections. Objective: To validate a nonsurgical therapeutic approach for correcting a “saddened” appearance characterized by drooping mouth corners, oral commissures, and/or marionette lines. Methods: In this prospective, evaluator-blinded study, monophasic hyaluronic acid (MHA) was infiltrated to correct drooping mouth corners in four steps, deep oral commissures in two steps, and/or deep marionette lines in two steps, in that order. Then, incobotulinumtoxinA was injected along the depressor anguli oris and mentalis muscles. Results: The total volumes of MHA used in steps 1-4 were 0.2 mL (interquartile range [IQR]: 0.19-0.3) for the right side of the face and 0.25 mL (IQR: 0.2-0.3) for the left side; total volumes in steps 5-8 were 0.18 mL (IQR: 0-0.4) for the right side and 0.15 mL (IQR: 0-0.33) for the left side. The total mean dose of incobotulinumtoxinA was 26.5 units (IQR: 24-28). The median degrees of drooping of the mouth corners were −4° (IQR: −7° to −2°) at baseline, −1° (IQR: −3° to 1°) at post-treatment 2 weeks, and −1° (IQR: −3° to 0°) at post-treatment 3 months. Median Global Aesthetic Improvement Scale scores were 3 (IQR: 2-3) at post-treatment 2 weeks and 3 (IQR: 2-3.75) at 3 months. Conclusion: Our results demonstrated that nonsurgical treatment with MHA and incobotulinumtoxinA provides satisfactory therapeutic outcomes in patients with a saddened appearance by correcting drooping of the mouth corners, deep oral commissures, and/or deep marionette lines.

KW - cohesive polydensified matrix hyaluronic acid

KW - incobotulinumtoxinA

KW - marionette line

KW - melomental fold

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KW - oral commissure

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