Introduction of the Microdroplet Technique with Incobotulinumtoxin A for the Treatment of Crow's Feet.

To investigate the efficacy and safety of the addition of the microdroplet technique to conventional injections for the treatment of crow's feet with incobotulinumtoxin A, four women with moderate-to-severe crow's feet at maximum expression received three standard intradermal injections of incobotulinumtoxin A on both sides of the face (4U [0.1mL] at each injection point) plus six microdroplet injections of incobotulinumtoxin A (0.5U [0.025mL] per point) into the lateral canthal area on the left side of the face and an equal quantity of saline at the same injection points on the right side of the face. Investigators and subjects independently evaluated the degree of rhytide improvement both at rest and maximum expression after 28 and 84 days. Investigator and subject ratings for wrinkle severity at maximum expression were improved to a greater degree on the side of the face treated with additional microdroplet incobotulinumtoxin A in all subjects, except one who was over 65 years old. All women preferred the results on the left side of their face. Treatment was well tolerated. The addition of the microdroplet technique to standard practice for injecting incobotulinumtoxin A is a promising procedure for the treatment of crow's feet in women with moderate-to-severe wrinkles.