Part 5 - Neuromodulator Education

This page contains educational resources specific to the neuromodulators and fillers available at Peach Skin Clinic. This page is not meant to diagnose or recommend. If you have any questions, please contact us at one our facilities. 


Botox & Dysport treatment techniques

The following guideline for the typically techniques that are used to in Botox and Dysport treatments.

Glabella lines

One of the most common areas treated in the USA. The glabella is the area between the eyes. When the area is pulled together, it creates a frown expressions. The lines or lines that are created during the expression are known as number eleven lines. Muscle treated: Frontalis (lifts eyebrows). The main muscles that are targeted for this treatment are the corrugator, the procerus, and the frontalis, and possibly the nasalis. 

Sex is a variable that is considered in the dosing and the technique. Male patients will need more medication in order to achieve the same results when compared to female patients. 

Some health professionals use an electromyogram machine to locate the muscle before injecting. However, it is highly recommended to have an understanding of the muscle anatomy and movement for a more flexible and expert approach. During the treatment, the health professional should ask the patient to create a frowning expression in order to understand their muscle movement and where the belly of the muscles are located. The recommended method is to insert the needle into the muscle belly until a pop is heard. The needle should be inserted perpendicular into the belly an the muscle and have the dosing be injected. 

The most common complication in this area is eyelid ptosis. This happens when the treatment is too low over the brow arch. 

Forehead Lines

When a patient lifts their eyebrows towards their hairline, forehead wrinkles will form. Some patient have a lot of wrinkles and others may have very little. These specific wrinkles are performed by the frontalis muscle. Although this treatment, at first glance, looks simple, their exists a lot of variability. This is the reason why thorough consultation is required and highly recommended. Many patients do not fully appreciate how much they use their forehead until they are unable to use it. This treatment will also effect the position of the eyebrow. The eyebrows, after the results, may become more flat or arched. 

Before beginning treatment, it is important to remember that being conservative with the frontalis is better than aggressive. Since the muscle is susceptible to dosing, overdoing it can cause results that the patient does not want. The treatment will typically require 20 to 30 units and about 50 units for male patients. The first step to have the patient lift their brow and evaluate where the pulls are. Health professionals should be sure that the needle is inserted just below the wrinkle. The next step is to repeat the process but work laterally. Health professionals should not inject close to the eyebrow arch because this may cause ptosis. Massaging the area immediately after may be done. However, the massaging direction is towards the hairline. 

Crow's feet

The muscle that creates the crow's feet to be formed is called the orbicularis oculi. When treating this muscle it is important that diffusion rate remain minimal since this muscle is small. A high concentration and low volume dilution rate is optimal. Their are two routes that injectors may take when treating this area. They are intramusclular and subcutaneous. The intramuscular is the recommended because it allows more consistent results. The subcutaneous method is typically used by beginning injectors as to avoid any bruising. Three to four injection sites are placed about a finger breath from the lateral canthus of the eye. Patients may be asked to wrinkle their eyes in order to observe the formed wrinkles more clearly. The injection sites must be chosen based on the greatest number of lines formed. The farther the injection side from the lateral canthus is moved, the more risk of bruising will occur.  Piercing the zygomaticofacial artery and the orbital vein will cause a very large bruise.