Botulinum toxin for periocular lines: the single-injection technique

Summary Background  Botulinum is a well established treatment for facial wrinkles and hyperfunctional lines, including those at the periocular area. Objective  To illustrate a simple periocular injection technique. It differs from the usual one since it is a single injection, instead of several. Methods  Thirty consecutive patients were treated with this technique on one side, and the standard multipuncture technique on the contralateral side. Each patient, being their own control, received 10–12 Botox units to each side. The orbicularis oculi muscle was injected using two different types of needles: a standard 30 g 13 mm needle for the multipunctured side and a 30 g 25 mm needle for the single puncture side. Follow up assessments were made on days 7, 15 and 120. Results  Good results were achieved in all patients. No relevant cosmetic difference was noticeable between the two sides. The pharmacological effect lasted about 5 months, with no difference between the two techniques. Both techniques were safe and caused the same amount of bruising. The single injection was preferred by patients. The single-injection technique, on the other hand, requires more skill and experience by the operator. Conclusions  The single-injection technique for periocular lines is a useful alternative to the standard multipuncture technique. It reduces patients’ discomfort.