Pearls and Pitfalls of Neurotoxins and Facial Fillers

Success in the use of neurotoxins and fillers in the face relies on accurate analysis of the area(s) to be treated and correct application of the appropriate techniques for correction of each proposed area. There are a number of personal preferences in syringe and needle types for injection of neurotoxins. Obliquely oriented "inverted V shaped" lines are a result of contraction of the paired corrugator supercilii muscles. The depressor anguli oris (DAO) is responsible for pulling down the lateral commissure of the lip. Treatment of the DAO with neurotoxin will serve to weaken this function and allow for relatively unopposed zygomaticus major muscle contraction resulting in elevation of the corners of the mouth. Low or intermediate viscosity hyaluronic acid fillers are preferred in treating the labiomental groove. Lip injections can be one of the most appearance enhancing techniques in facial filler use.