Abstract：
BACKGROUND: The safety and efficacy of botulinum neurotoxin type A (BoNTA) treatments are well established, but injection techniques, target muscles, and toxin doses continue to evolve, with each refinement producing improvements in treatment outcomes. The recommendations in this consensus move away from standard templates and illustrate how to tailor treatments to individual patterns and strengths of muscle activity, and patient preferences.
METHODS: Seventeen experts in the fields of plastic surgery, dermatology, ophthalmology, otorhinolaryngology, and neurology convened in 2022 to develop consensus-based recommendations for the use of botulinum toxin A for the treatment of horizontal forehead lines, glabellar frown lines, and crow\'s feet lines that reflect current clinical practice. The focus was on how to tailor injections to individual patients to optimize treatment outcomes.
RESULTS: For each upper face indication, consensus members describe how to perform a dynamic assessment to optimize the dose and injection technique for each patient. A tailored treatment protocol is presented for commonly observed patterns of dynamic lines. Units of Inco are defined and the precise location of injection points, illustrated with the use of anatomical images.
CONCLUSIONS: This consensus provides up-to-date recommendations on the tailored treatment of upper facial lines based on the latest research and collective clinical experience of the expert injectors. Optimal outcomes require thorough patient evaluation, both at rest and during animation, using both visual and tactile cues; detailed understanding of facial muscular anatomy and how opposing muscles interact; and use of a BoNTA with high precision to target identified zones of excess muscle activity.
METHODS: Seventeen experts in the fields of plastic surgery, dermatology, ophthalmology, otorhinolaryngology, and neurology convened in 2022 to develop consensus-based recommendations for the use of botulinum toxin A for the treatment of horizontal forehead lines, glabellar frown lines, and crow\'s feet lines that reflect current clinical practice. The focus was on how to tailor injections to individual patients to optimize treatment outcomes.
RESULTS: For each upper face indication, consensus members describe how to perform a dynamic assessment to optimize the dose and injection technique for each patient. A tailored treatment protocol is presented for commonly observed patterns of dynamic lines. Units of Inco are defined and the precise location of injection points, illustrated with the use of anatomical images.
CONCLUSIONS: This consensus provides up-to-date recommendations on the tailored treatment of upper facial lines based on the latest research and collective clinical experience of the expert injectors. Optimal outcomes require thorough patient evaluation, both at rest and during animation, using both visual and tactile cues; detailed understanding of facial muscular anatomy and how opposing muscles interact; and use of a BoNTA with high precision to target identified zones of excess muscle activity.
摘要：
背景：A型肉毒杆菌神经毒素（BoNTA）治疗的安全性和有效性已得到证实，但是注射技术，目标肌肉，毒素剂量继续进化，每次改进都会改善治疗结果。本共识中的建议远离标准模板，并说明如何根据肌肉活动的个体模式和强度定制治疗方法。和患者偏好。
方法：整形外科领域的17位专家，皮肤病学,眼科,耳鼻咽喉科,和神经科于2022年召开会议，为使用肉毒杆菌毒素A治疗水平前额线制定基于共识的建议，眉间皱眉线，和乌鸦的脚线，反映了当前的临床实践。重点是如何为个体患者定制注射剂以优化治疗结果。
结果：对于每个上面部适应症，共识成员描述了如何进行动态评估以优化每位患者的剂量和注射技术.针对常见的动态线模式，提出了量身定制的治疗方案。定义了Inco的单位和注射点的精确位置，使用解剖图像进行说明。
结论：该共识根据专家注射器的最新研究和集体临床经验，提供了有关上面部线条定制治疗的最新建议。最佳结果需要彻底的患者评估，在休息和动画期间，使用视觉和触觉提示;详细了解面部肌肉解剖结构以及相对肌肉如何相互作用;并使用具有高精度的BoNTA来瞄准识别出的过度肌肉活动区域。
方法：整形外科领域的17位专家，皮肤病学,眼科,耳鼻咽喉科,和神经科于2022年召开会议，为使用肉毒杆菌毒素A治疗水平前额线制定基于共识的建议，眉间皱眉线，和乌鸦的脚线，反映了当前的临床实践。重点是如何为个体患者定制注射剂以优化治疗结果。
结果：对于每个上面部适应症，共识成员描述了如何进行动态评估以优化每位患者的剂量和注射技术.针对常见的动态线模式，提出了量身定制的治疗方案。定义了Inco的单位和注射点的精确位置，使用解剖图像进行说明。
结论：该共识根据专家注射器的最新研究和集体临床经验，提供了有关上面部线条定制治疗的最新建议。最佳结果需要彻底的患者评估，在休息和动画期间，使用视觉和触觉提示;详细了解面部肌肉解剖结构以及相对肌肉如何相互作用;并使用具有高精度的BoNTA来瞄准识别出的过度肌肉活动区域。
