Microdroplet Botulinum Toxin: A Review

Abstract

Microbotox is the administration of multiple microdroplets of botulinum toxin in intradermal plane. It is increasingly becoming popular owing to its more favorable outcome and better safety profile than the conventional technique. The intention is to treat fine lines and wrinkles without imparting an undesired "frozen face like" appearance. Besides facial rejuvenation, it has found its way into the management of other indications such as rosacea, hyperhidrosis, keloid, and seborrhea. Being a relatively newer method, knowledge about the various dilution methods, desired volume, and correct depth of injection involved in this technique remain scarce. In this article, the authors have highlighted various indications, procedures, adverse effects, and contraindications of microbotox.

Keywords: Botulinum toxin; facelift; facial wrinkles; mesobotox; microbotox; microdroplet technique.

Figure 1

(a) Traditional technique of administration of botulinum toxin into the deeper fibers of the muscle. (b) Microdroplet technique showing administration of neurotoxin in intradermal plane, into the superficial muscle fibers thus sparing the deeper muscle fibers.

Figure 2

Combination of microdroplet BoNT with traditional botulinum toxin for brow lift.

Figure 3

(a) Microdroplet technique for mid-facelift, administered in a grid pattern, with injection points 0.5–1 cm apart. (b) Alternative technique for mid-facelift with injection points in two rows over the frontalis, two rows at the temples along the hairline, lateral orbicularis oculi, pre auricular at the level of the tragus and along the mandibular line at 1 cm intervals.

Figure 4

Mid facelift demonstrating a rested appearance with microbotox technique, 20 U ONA in 1 mL of solution (right).

Figure 5

Target zone for lower face and neck lift with microdroplet technique.

Figure 6

(a) “Crepe-like” skin on the neck, (b) neck lift with microdroplet technique demonstrating improvement post-administration of 42 U of ONA.

Figure 7

(a) Post-burn keloid on the neck (left), (b) Significant softening and improvement in range of motion with single session of 24 U in 1 mL solution of medytox combined with intralesional triamcinolone acetonide (40 mg/mL).