OBJECTIVE
To present an original classification of mimic patterns of the lower third of the face and facial contour correction with botulinum toxin type A (BTA).
MATERIAL AND METHODS
A prospective observational study included 134 patients for the period from September to December 2015. Involvement of DAO (depressor anguli oris), mentalis muscle and platysma muscle in mimic test and involuntary facial expressions was assessed. The patients were divided into several age groups: group 1 (20—30 years old) — 18 patients, group 2 (31—40 years old) — 44 patients, group 3 (41—50 years old) — 44 patients, group 4 (over 50 years old) — 28 patients. In 48 patients, facial contours were corrected with BTA and “three-level” injection technique. The outcomes were evaluated considering the photos before and in 14—18 days after the procedure. Physician and patients themselves assessed the results in accordance with GAIS scale. For botulinum toxin therapy, AboBTA was used (20 U/0.1 ml). Bilateral injections into DAO and platysma muscle were performed. Injections into mentalis muscle were applied if it was indicated.
RESULTS
There were 5 different patterns of facial muscle contraction in the lower third of the face: isolated (DAO contraction only) — 14.5%, consensual (contraction of DAO and platysma) — 36.2%, platysmal (platysma contraction only) — 24.2%, antagonistic (contraction of DAO and mentalis muscle) — 3.9%, combined (contraction of DAO, platysma and mentalis muscles) — 24.2%. Platysmal variant was observed in almost 1/2 of patients over 50 years old (46.5%) and none patient under 30 years old. Isolated pattern was found in 1/3 of patients under 30 years old and none patient over 50 years old. Facial contour correction with “three-level” technique was effective in all 48 patients (GAIS score of physician satisfaction 2.8 and patient satisfaction 2.6). No serious side effects occurred.
CONCLUSION
The proposed classification of mimic patterns can be used for planning facial contour correction, selecting target muscles and correction method. «Three-level» technique is effective in patients with any variant of mimic pattern with minimal risk of unwanted effects.
