Forehead lines seen at maximum eyebrow elevation

Active Ingredient: Botulinum toxin type A

Indication for Botulinum toxin type A

Population group: only adults (18 - 65 years old)
Therapeutic intent: Curative procedure

For this indication, competent medicine agencies globally authorize below treatments:

20 Units as 4 Units injections across 5 sites

For:

Dosage regimens

Intramuscular, 20 international units botulinum toxin type A, once every 3 months.

Detailed description

Recommended needle: Sterile 30 gauge needle.

Administration guidance:

To identify the location of the appropriate injection sites in the frontalis muscle, assess the overall relationship between the size of the subject’s forehead, and the distribution of frontalis muscle activity should be assessed.

The following horizontal treatment rows should be located by light palpation of the forehead at rest and maximum eyebrow elevation:

  • Superior Margin of Frontalis Activity: approximately 1 cm above the most superior forehead crease
  • Lower Treatment Row: midway between the superior margin of frontalis activity and the eyebrow, at least 2 cm above the eyebrow
  • Upper Treatment Row: midway between the superior margin of frontalis activity and lower treatment row

The 5 injections should be placed at the intersection of the horizontal treatment rows with the following vertical landmarks:

  • On the lower treatment row at the midline of the face, and 0.5-1.5 cm medial to the palpated temporal fusion line (temporal crest); repeat for the other side.
  • On the upper treatment row, midway between the lateral and medial sites on the lower treatment row; repeat for the other side.

Figure:

Care should be taken to ensure that botulinum toxin type A is not injected into a blood vessel when it is injected in the forehead lines seen at maximum eyebrow elevation.

Recommended dose:

A volume of 0.1 ml (4 Units) is administered in each of the 5 injection sites in the frontalis muscle, for a total dose of 20 Units in a total volume of 0.5 ml (see Figure).

The total dose for treatment of forehead lines (20 Units) in conjunction with glabellar lines (20 Units) is 40 Units/1.0 mL.

For simultaneous treatment with glabellar lines and crow’s feet lines, the total dose is 64 Units, comprised of 20 Units for forehead lines, 20 Units for glabellar lines, and 24 Units for crow’s feet lines.

Additional information: Treatment intervals should not be more frequent than every 3 months.

The efficacy and safety of repeat injections of botulinum toxin type A for the treatment of forehead lines beyond 12 months has not been evaluated.

Active ingredient

Botulinum toxin type A

Botulinum toxin type A is a protein complex derived from Clostridium botulinum. The protein consists of type A neurotoxin and several other proteins. Under physiological conditions it is presumed that the complex dissociates and releases the pure neurotoxin. Intramuscular injection of the neurotoxin complex blocks cholinergic transport at the neuromuscular junction by preventing the release of acetylcholine. The nerve endings of the neuromuscular junction no longer respond to nerve impulses and secretion of the chemotransmitter is prevented (chemical denervation).

Read more about Botulinum toxin type A

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