Case Report

A 54-year-old patient had severe horizontal wrinkles in the frontal area, vertical wrinkles in the glabellar area and crow’s feet. In addition, there were also changes in the lower third of the face in the form of activity of m. mentalis, m. DAO, m. platysma.

Furthermore, the patient had low tails of the eyebrows.

Patient had a porous and thick skin with a severe form of cuperose. Subcutaneous fat was expressed moderately. Muscles did, however, not have excessive hypertonicity.

Treatment regimen: 

Dysport 500 U was dissolved with 1,25 ml of saline.

1. frontalis – 7 points. In each point – 8 U. Injections were made at the top of the muscles, superficially, by V drawing.
2. procerus – 8 U. M. corrugator – 8 U and 4 U on each side. M. depressor supercilii – 2 U on each side. Lateral side of MOO.

5 points in staggered order in two lines (1 – stepping from the edge of the orbit by 1 cm and the second by 0.2-0.3 cm from the first). At each point of the first line – 8 U. At each point of the second line – 4 U. Lower eyelid – 2 points to the pupillary line of 2 U. For correction of the tail of the eyebrows – 2 points of 4 U. The first point at the intersection of the line drawn from the alae of the nose along the lateral edge to the intersection with the eyebrow. The second was at the intersection of the line drawn from the alae of the nose along the edge of the iris to the eyebrow.

The spine of the nose was injected to decompensate wrinkles. Used for 4 U in each part of m. nasalis pars transversa.

Fig. 1.

For correction of m. mentalis, at the central point – 10 U of Dysport. To determine the point for correction, M. DAO – step back 2 cm from the commissure laterally and 3 cm perpendicular down. A dose of Dysport 4 U allowed to correct the lowered corners of the mouth. Align the oval allows injection in M. platysma at 1 cm above the edge of the lower jaw. Three points are used – 4 U of Dysport on each side.

Fig. 2.