{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:41:19Z","timestamp":1792003279969,"version":"4.4.0"},"reference-count":10,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"ABSTRACT<\/jats:title>Background<\/jats:title>Platysmal bands contribute to neck ageing and lower\u2010face descent. Although botulinum toxin A (BoNT\u2010A) is approved for this indication, conventional whole\u2010muscle dosing requires many superficial injections with attendant risks.<\/jats:p><\/jats:sec>Objective<\/jats:title>To develop an anatomically guided protocol that targets motor\u2010dense zones of the platysma, optimizing efficacy while reducing dose and complications.<\/jats:p><\/jats:sec>Methods<\/jats:title>Sihler\u2010stained dissections mapped motor versus sensory innervation. Ultrasound\u2010guided injections were performed in 40 patients, delivering 30\u201360\u2009U BoNT\u2010A per side at 15 sites concentrated in the upper two\u2010thirds of the platysma and along the marginal mandibular border. Outcomes included band severity, jawline definition, adverse events, and cost.<\/jats:p><\/jats:sec>Results<\/jats:title>Motor end\u2010plates clustered in the upper platysma; the lower third was largely sensory. Targeted injections produced a \u2265\u20092\u2010grade reduction in dynamic bands in 92.5% of patients by week 4, maintained through week 12. Mean toxin use fell 35% versus historical whole\u2010muscle protocols; bruising dropped to 5%, with no dysphagia or lower\u2010face weakness. Treatment costs were proportionally lower.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Concentrating BoNT\u2010A in the motor\u2010rich upper platysma under ultrasound guidance maximizes aesthetic improvements while minimizing dose, discomfort and adverse events. This neural distribution\u2010based algorithm offers a safer, more economical alternative to conventional platysmal band treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.70301","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T22:59:19Z","timestamp":1750978759000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Optimizing Botulinum Toxin Injections in the Platysma Muscle Based on Motor Nerve Distribution"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5572-1364","authenticated-orcid":false,"given":"Kyu\u2010Ho","family":"Yi","sequence":"first","affiliation":[{"name":"Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project Yonsei University College of Dentistry Seoul Korea"},{"name":"You and I Clinic Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac Kai Jie","family":"Wong","sequence":"additional","affiliation":[{"name":"The Artisan Clinic Private Limited Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jovian","family":"Wan","sequence":"additional","affiliation":[{"name":"Medical Research Inc. Wonju Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002894"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000000177"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199611000-00011"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/14764170701545657"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000082203.65641.DD"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.5115\/acb.22.258"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-019-01396-4"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjy179"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjad148"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxins14120868"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.70301","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T05:31:30Z","timestamp":1755581490000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.70301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,26]]},"references-count":10,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/jocd.70301"],"URL":"https:\/\/doi.org\/10.1111\/jocd.70301","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,26]]},"assertion":[{"value":"2024-10-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70301"}}