2013
DOI: 10.1590/s0365-05962013000100024
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Combined treatment with botulinum toxin and hyaluronic acid to correct unsightly lateral-chin depression*

Abstract: With aging, anatomical changes are observed in the face. In the lower third, these changes are expressed as ptosis of the angle of the mouth, lip enhancement groove mentalis; decrease in concavity between the jaw and neck and very noticeable platysmal banding. The repeated contraction of muscles of the lateral-chin together with the band platysmal side form what are called a marionette groove. Treating the whole lateral-chin area can result in a more harmonious aspect of the face when compared with treatment o… Show more

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Cited by 9 publications
(3 citation statements)
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“…This study extends the findings of past studies of the concurrent use of botulinum toxin and soft‐tissue augmentation materials, particularly hyaluronic acid fillers. Such combination use has previously been reported for esthetic improvement of the chin, the lower face, nasolabial folds, nose, periocular area, and glabellar area . This is the first study we are aware of that studies the utility of combination treatment for forehead wrinkles.…”
Section: Discussionmentioning
confidence: 77%
“…This study extends the findings of past studies of the concurrent use of botulinum toxin and soft‐tissue augmentation materials, particularly hyaluronic acid fillers. Such combination use has previously been reported for esthetic improvement of the chin, the lower face, nasolabial folds, nose, periocular area, and glabellar area . This is the first study we are aware of that studies the utility of combination treatment for forehead wrinkles.…”
Section: Discussionmentioning
confidence: 77%
“… 61 This treatment creates a smooth, uninterrupted subcutaneous layer. However, the pre-jowl sulcus and chin should be treated with a dual-plane technique using HA filler, both above and below the muscle, 62 , 63 using a combination of high G’ and softer fillers. All fillers with low G’ and low cohesiveness, such as Juvederm Volbella, are less viscous and are likely to spread more in the surrounding tissue after injection, thus allowing for the achievement of a hydro lift effect.…”
Section: Discussionmentioning
confidence: 99%
“…1,2 Contractions of the platysma, depressor anguli oris, and mentalis muscles contribute to marionette lines. 3 There are 2 underlying structural fixation points that anatomically define the marionette line: the cutaneous insertion of the depressor anguli oris muscle (superior border) and the attachment site of the mandibular ligament (inferior border). 1 The lateral pull exerted by the zygomaticus major and platysma muscles at these 2 fixation points, which occurs with facial animation, reveals the entire length of this natural fold.…”
mentioning
confidence: 99%