New Glabella Botulinum Toxin Pattern

Recently Professor Cotofana published an important new paper exploring an alternative botulinum toxin injection pattern for glabella treatments. In this clip, I share my thoughts on the paper.
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[@AdccUs]

Excellent comments. I've been doing this technique for years and it is very effective and very predictable. I teach Cadaver anatomy, facial injectables and complications at the International Academy of Facial Aesthetics each year and recently Botox certification classes at the Florida Dental Association annual symposium in Orlando Florida. We had over 100 doctors in the class and I was again amazed at how many were taught a "COOKBOOK" approach to injecting without the complete knowledge of the anatomy of the face. The technique you describe in your video is excellent and embraces the anatomy of the Corrugators Muscles at the insertion point at the medial inferior border of the superior orbit. A deep injection into the body of the muscle here eliminates the Frontalis Muscle and the Orbicularis Oculi(Orbital Portion) all together as well.. As you stated in the video if the patient wants a little less movement then a more superficial injection can be made laterally as the Corrugator Muscle moves from its deep insertion point in a lateral direction and more superficial. If this injection is shallow then the orbital retaining ligament will act as a barrier for the migration of the Neurotoxin into the lid, thus eliminating lid ptosis as well. Thank You Dr. Pearce for your excellent presentations. I inform all my students of your you tube video series and encourage them to watch a learn all they can. Dr. J Terry Alford ( Clinical Director-Advanced Laser Training Institute and the Advanced Dental Cosmetic Center).

[@karenwalker4476]

That’s why Dr. Tim is such a respected man in his field!😁👍

[@joanneangove9397]

This is what I was looking for thank you! I wanted a remedy in case this techniques fails and the lateral brow is too elevated.

[@JuleCor]

So insightful. Thank you!

[@jokepple6792]

So pleased to see this. I have had a ptosis three times now, from very experienced practitioners. Poor things, they all said, ‘I’ve never caused a ptosis, don’t worry’ 😂. So now we don’t do the mid-brow at all. No ptosis, still a great result 👍🏻

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[@jokepple6792]

@@lucillebennet4233 don’t be a troll

[@lucillebennet4233]

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[@jokepple6792]

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[@alekjfisher]

Dr Pierce- What is the difference in terms of the injection angle with the 3-point technique? I asked this question a while back in a previous comment but never got a response. I would be oh so grateful to hear a quick answer to this!! Love your videos.

[@juliemcgrattan1198]

Hi l can’t see think links to papers in the bio?

[@jerryodriscoll7189]

Is there anywhere we can see the technique being performed? thanks

[@alekjfisher]

Dr. Pierce! Quick important question - you state in your other video about this new pattern that, with the modified, 3-injection-point technique, that "the biggest difference is that you're not injecting the lateral part of the corrugator muscle; there's also some difference in the angle of injection" - but you don't elaborate further on the angle of injection/injection technique with the corrugators here. Can you please explain / reply and tell me what the difference is with the corrugator injection angle when doing the new 3-injection glabella technique? do you inject more in the middle portion of the corrugator or do you still insert the needle in the medial portion? What exactly is different?
I showed this video with my injector and I am interested in having her try this technique but first just want to clarify what is done differently with the corrugator injections using this technique.
Thank you tremendously in advance for your response I would really appreciate it!!! :)

[@ImpressiveBassist]

Thank you for your quality content. I have a question: Is a 4mm 32g needle suitible for this tecnique or Is It too short?

[@DrTimPearce]

It could be for some patients but depends on the thickness of their skin. But we usually use the full depth of the BD insulin syringe for deep glabella injections so 4mm would be too short.
Kind regards Mary. Clinical Advisor for Dr Tim

[@timrai2100]

Where do you get the injection practice dummy?

[@DrTimPearce]

Dr Tim makes most of his own using plastercine however there are a couple you can purchase from
www.zancomodels.co.uk which focuses on facial anatomy
Kind regards Mary. Clinical advisor for Dr Tim

[@DrTimPearce]

Dr Tim makes most of his own using plastercine however there are a couple you can purchase from
www.zancomodels.co.uk which focuses on facial anatomy
Kind regards Mary. Clinical advisor for Dr Tim

[@joannelapadura6182]

It seems like when I get Botox I always end up getting Spock brow

[@adrianparker6996]

I think i need help interpreting this: The before and after images of the woman: are we looking at a desired outcome or a side effect? (Because in my opinion the effects of Botox are not working for that patient, she looked way better before)