<p>One21: A Novel, Customizable Injection Protocol for Treatment of the Forehead with IncobotulinumtoxinA</p>

Abstract

It is well known that incobotulinumtoxinA (INCO) is an effective approved treatment for dynamic wrinkles of the upper face caused by the action of mimetic muscles over time. In doing so, it is important to maintain a balance between muscle groups and a natural facial appearance. Patients differ enormously in their facial anatomy regarding structure and function, both within and between genders, ethnicities, and age. Therefore, treating all patients with the same injection pattern and the same doses can result in undesired outcomes. There is a need for a tailored approach to achieve optimal results, as well as to increase patient satisfaction. With this in mind, the novel one21 injection technique which allows for individualized treatment has been developed for the treatment of horizontal forehead lines using INCO, resulting in a positive impact on eyebrow position and shape. This technique is the next step in a customized approach, giving natural-looking results and high patient satisfaction.

From Anatomical Modifications to Skin Quality: Case Series of Botulinum Toxin and Facial Fillers for Facial Feminization in Transgender Women

“…BonTA was injected into the forehead following the “One21” technique 6 to minimize dynamic wrinkles, and create a flatter and softer forehead, whereas frontalis muscle activity above the lateral one-third of the brow was retained to lift the eyebrow, giving the eyebrow a more angled shape. 5 Treatment of the glabella with high doses of BonTA aimed at glabellar complex weakening and eyebrow arching ( Figures 1 and 4–8 ).…”

Botulinum Toxin Type A to Improve Facial Symmetry in Facial Palsy: A Practical Guideline and Clinical Experience

“…The ideal injection framework, as well as mean doses needed to restore facial symmetry for each muscle group remain empirical. Dose ranges suggested for the injection for each muscle of facial expression in Table 2 were based on previous review studies of BoNT-A use in facial palsy [ 12 , 13 , 14 , 15 , 17 , 26 ] and BoNT-A in aesthetic medicine [ 36 , 37 , 38 ].…”

“…In order to balance this compensatory hyperactivity on the non-paralyzed side, high doses should be injected into the frontalis muscle and the brow depressors ( Figure 2 ) [ 13 ]. While defining the distribution of injection points and BoNT-A dose, palpation of the forehead while the patient contracts the frontalis allows a better assessment of the presence or absence of muscle contraction, as well as of muscle strength [ 38 ].…”

ONE21 technique for an individualized assessment and treatment of upper face wrinkles in five pairs of identical twins with IncobotulinumtoxinA

“…However, because patterns of muscular contraction differ among patients, it is difficult to homogenize groups and, consequently, analyze the results. 3 When patients are categorized by age, gender, ethnicity, and dynamic wrinkle degree, their individual anatomy, habitual use, mass, and muscle strength are often not considered.…”

“…The protocol may be personalized to each patient's aesthetic demands and their anatomical particularities. 3,6 Further, we evaluated the particularities of dynamic upper facial lines in identical twins, based on an assessment of the functional anatomy and the patient's desired outcomes, and performed a customized injection of incobotulinumtoxinA using the ONE21 technique.…”