Classification of periorbital wrinkles and treatment with Botulinum Toxin Type A

Introduction: Periorbital wrinkles are an important component of facial aging that can be minimized with botulinum toxin treatment. Objective:To treat periorbital wrinkles through botulinum toxin injections in the orbicularis muscle, using classic lateral points and additional points in the lower eyelid, which were developed based on the classification of these wrinkles. Methods: Clinical and photographic data from 530 patients who had periorbital wrinkles classified and treated between 2002 and 2007 were analyzed. Results: Thirty percent of patients over 45, and 80% of those under 45, demonstrated complete improvement of the wrinkles after treatment in the classic points. The remaining patients needed treatment in the additional points in the lower eyelids. Conclusion: The classification of wrinkles helped improve treatment. Despite the considerable benefit offered by injecting in the classic points, the necessity of treating additional points in the lower eyelids with botulinum toxin was verified. The presence of subcutaneous cellular tissue and the patient’s age should also be taken into consideration.