Heterogeneous crow's feet line patterns and customized botulinum toxin rejuvenating treatment

• DOI: 10.1111/jocd.15172
• Publication Date: 2022-06-20T16:27:04Z
• Authors: Maurizio Cavallini; Marco Papagni; Federica Augelli; Gabriele Ferrucci...; Adriano Santorelli; Mauro Raichi
• Keywords: Adult; Aging; 03 medical and health sciences; 0302 clinical medicine; Adolescent; Esthetics; Neuromuscular Agents; Humans; Middle Aged; Botulinum Toxins, Type A; Skin Aging

Abstract Background From early dynamic lines in smiling and squinting young people, crow's feet the lateral canthal region evolve through prolonged tissue remodeling into mature, stable rhytids after mid‐to‐late thirties, requests for rejuvenating treatment. Because of heterogeneous fanning behavior lines, individualizing neuromodulation with botulinum toxin injections might be a sound strategy to maximize aesthetic outcomes. Aims To investigate prevalence variable line patterns at maximum contracture while comment on relative distribution such influence aging. These considerations will basis rationale future studies that individualize total 24‐unit dose according lines. Methods Identifying CFL orientation frown smiling; assessment tool: four‐class 2015‐version Kane's classification further modified by converting former “central fan pattern” new, more precisely defined “extended full‐fan class. Results The 323 cohort subjects had mean age 51.5 ± 9.28 years. Although some differences, outcomes central‐southern real‐world European Caucasian population appear similar first studied 2003 highly selected New England involved double‐blind clinical trials. pattern predominated both contraction when smiling, followed upper‐fan extended smiling. Age significantly influenced pattern—lower‐fan were frequent than other younger middle‐age group (40–49 years old); progressively prevalent Conclusions study confirms but somewhat modifies previous evidence about non‐homogeneous different groups reinforces case topography injections.