Clearly there is a lot to know about how to inject Botulinum Toxin but when you get down to the clinical part of injecting there are 3 fundamentals - SITE, DEPTH and DOSE.
If you know where on the face you are going to inject (SITE), how deep you are going to inject (DEPTH) and how much you are going to inject (DOSE), you should be able to inject anywhere on the face (as long as there is clinical indication/appropriateness and you can physically use a syringe).
Let’s look at these 3 in a bit more detail.
SITE:
When we consider site we are referring to the injection points. Many of you will use facial landmarks to determine these points but it is important to actually activate the muscle to confirm and check that these points are appropriate. You should never rely on facial landmarks only but they can certainly help with not only determination of the approximate location of the injection site but also provide relative safety zones e.g. staying at least 1cm away from the orbital rim.
As an example let’s use the forehead and frown (glabellar) region. Reasonable sites for injecting these areas with Botulinum Toxin may be the following:
DEPTH:
Once we have established the injection points (i.e. site) consider how deep the muscle is lying. In this case we can say that the frontalis and the tail of the corregators are relatively superficial, the head of the corregators medium depth and the procerus deeper.
DOSE:
Once you know the location of the injections and how deep these injections need to be placed you can then consider dose.
It is always worth considering the manufacturers recommendation when determining dose. For the frontalis and glabellar regions the doses recommended are:
When deviating away from these doses it may be prudent to explain why e.g. an asymmetry.
The fundamentals of site, depth and dose can be applied to anywhere on the face and so breaking it up into these key 3 criteria can help make your life easier.
We hope this helps but if you have anymore questions please do not hesitate to contact us here.