الفهرس 
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Abstract
F
acial wrinkles possess a psychological burden to affected patients especially female patients. Several factors participate in the pathogenesis of facial aging such as environmental, stress, pollution and hormonal factors. Various treatment modalities were prescribed in the field of facial rejuvenation botulinum toxin, fillers, mesotherapy, PRP, and skin resurfacing.
Botulinum toxin (BoNT) has been widely used to correct facial wrinkles. As a result, many consider BoNT synonymous with cosmetic dermatology. Recent studies indicate that BoNT elicits biological effects on various skin cell types via the modulation of neurotransmitter release, and it seems that BoNT has a wider zone of dermatologic influence than originally understood. Clinicians and researchers are now beginning to explore the potential of BoNT beyond the amelioration of facial lines and encouraging results are seen with BoNT in a variety of skin conditions.
In the current study we aimed to evaluate and compare between different dilutions of microBoNT-A in mid and / or lower facial rejuvenation and this to the best of our knowledge, is the first study in literature addressing this point. This work included 30 patients complaining of facial wrinkles. Patients were divided into three equal groups to study three different dilutions of microBoNT-A 1:5, 1:7 and 1:10. Response to treatment was assessed using the antera 3D camera in combination with patient satisfaction questionnaire and global aesthetic improvement scale (GAIS).
Parameters assessed to figure out the best responsive concentration included wrinkle size, depth and width assessment, indentation index and texture roughness. All 5 parameters were significantly improved with the 1:5 dilution compared to 1:7 dilution then 1:10 dilution. Patients’ satisfaction revealed better response with the 1:5 dilution compared to the other two dilutions. MicroBoNT-A, is a safe and cost effective tolerable line of treatment for periorbital and midface wrinkles with minimal side effects.