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Locking the line of convergence by botulinum toxin type A for the treatment of dynamic forehead wrinkles
Authors:Yehia F El-Garem MD  Amira Abulfotooh Eid MD  Tahra M Leheta MD
Institution:1. Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Alexandria, Egypt;2. Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
Abstract:

Background

Treatment of horizontal forehead lines with botulium toxin type A is a common procedure that helps achieve a youthful and rejuvenated look. Adequate knowledge of the anatomy and an individualized treatment approach is the key to successful treatment outcome.

Aim

To evaluate the cosmetic outcome following treatment of dynamic forehead wrinkles by locking the line of convergence using botulinum toxin type A.

Patients and Methods

Fifty female patients with dynamic forehead wrinkles were included. The line of convergence was identified, and injection points were determined. Patients received injections of botulinum toxin type A in the upper part of the frontalis along the line of convergence. Patients were evaluated before injection and the response was evaluated after 2 weeks and after 3 months of injection.

Results

Post-treatment significant decrease in dynamic wrinkle scale was detected. The distance between the medial and lateral canthi and their corresponding lower brow margins on maximum brow elevation was also significantly decreased after treatment. Meanwhile, the validated brow positioning score revealed no significant change in the resting brow position when pre-and post-treatment scores were compared.

Conclusions

Treating forehead wrinkles by injecting botulinum toxin along the line of convergence is an effective technique that requires less overall amount of toxin, improves the appearance of the wrinkles and minimizes the risk of development of side effects.
Keywords:botulinum toxin type A  dynamic forehead wrinkles  frontalis muscle  line of convergence
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