3D stereophotogrammetry quantification for tissue repositioning using Botulinum toxin A: a case report

Abstract

Hereby, we objectively assessed the outcomes of a facial-lifting procedure with Botulinum toxin type A (BoNT-A)using a 3D stereophotogrammetry quantification (3D-SQ). A 46-year-old female patient received a full faceBoNT-A treatment in a total dose of 180 Speywood Units (sU). Frontal, lateral and oblique photographs weretaken before and 20 days after treatment, at rest and during mimic movements. Also, a facial scanning wasperformed before and 20 days after BoNT-A injections. The results were analyzed using a 3D-SQ software. Thephotographs showed a decrease in expression lines and dynamic wrinkles. In addition, a better-defined jawlineand volume gain in the midface area with improvement of the profile appearance, due to the reduction of thesagging skin under the chin, was observed. The 3D-SQ showed volume gains of 1.17 ml on the right and of1.59 ml on the left cheekbone areas, due to the cranially soft-tissue repositioning. In addition, a decrease in thevolume of melomental folds areas (0.27ml on the right and 0.41 ml on the left side) was reported, compatibleto the above-mentioned volume gain. Measurements considering cephalometric points showed a decrease in thetotal facial height (distance from Trichion to Mental points), suggesting a soft tissue dislocation in an upwarddirection. Finally, this case report showed quantitative results that can evidence the role of BoNT-A in facialliftingprocedures. These results reinforce the importance of using a 3D-SQ to assess the outcomes of BoNT-Aand, probably, other aesthetic procedures. KEYWORDSBotulinum Toxin; Platysma; Facelifting; 3D images; Quantificare.