Comparison of Intradermal and Intramuscular Injection Technique in the Treatment of Inferior Periorbital Rhytids

Abstract

Botulinum toxin type A (Botox(superscript ®)) is well documented as a useful therapy for smoothening dynamic facial rhytids of the upper face. Most controlled studies have focused on the treatment of glabellar frown lines, horizontal forehead lines, and crow's feet. Reports of Botulinum toxin type A use in the inferior periorbital rhytids are few and anecdotal. We present our experience comparing intradermal and intramuscular injection with Botulinum toxin type A in inferior periorbital region for the treatment of inferior periorbital rhytids. Smoothening of inferior periorbital rhytids with opening of the palpebral aperture of lower eyelids were more obviously observed on the side receiving intradermal injection with diluted Botulinum toxin type A. However, treatment-related adverse events tended to occur more frequently with intradermal injection than intramuscular injection. As the results, we thought that intradermal injection with Botulinum toxin type A in inferior periorbital regions may provide an another choice of non-surgical treatment in periorbital rhytids.