Intradermal microbotox for improving skin quality in the lower third of the face and neck: a systematic review focusing on technical, anatomical, and safety aspects - Atena EditoraAtena Editora

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Intradermal microbotox for improving skin quality in the lower third of the face and neck: a systematic review focusing on technical, anatomical, and safety aspects

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Improving skin quality—including texture, micro-relief, sheen, visible pores, oiliness, and visual uniformity—has become a central therapeutic goal in cosmetic dermatology, especially in the lower third of the face and neck, regions with high anatomical complexity and functional risk in case of improper diffusion of botulinum toxin (BRANDT; BOKER, 2003; JABBOUR et al., 2017; YOUN et al., 2022). Microbotox (intradermal microdroplets of botulinum toxin type A) has been proposed to modulate skin attachments and superficial muscle fibers, aiming at natural skin quality outcomes (WU, 2015; KAUR et al., 2022; KASSIR et al., 2023). This systematic review (with structured narrative synthesis) summarized the mechanisms, technique, efficacy, and safety of intradermal microbotox for skin quality in the lower third and neck. The corpus included nine mandatory audited references, the study detailing dilution/microvolumes in an associated protocol (BERTOSSI et al., 2019), and four additional audited references that expand the evidence base for quantitative skin improvement, lifting effect, oiliness, and erythema (DIASPRO et al., 2020; NG; LELLOUCH, 2022; ROSE; GOLDBERG, 2013; YEH;
SHIH; HUANG, 2025). The findings support biological plausibility and clinical evidence for improved texture/sheen and smoothing of superficial cervical changes, as well as indirect benefits in soft tissue contour and ptosis when the application remains superficial (WU, 2015; AWAIDA et al., 2018; KASSIR et al., 2023; NG; LELLOUCH,
2022). Safety critically depends on the intradermal plane, microvolumes, patient selection, and anatomical mastery, especially of the platysma and perioral regions (BRANDT; BOKER, 2003; AWAIDA et al., 2018; YOUN et al., 2022).

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Intradermal microbotox for improving skin quality in the lower third of the face and neck: a systematic review focusing on technical, anatomical, and safety aspects

  • DOI: https://doi.org/10.22533/at.ed.1595322621012

  • Palavras-chave: microbotox; botulinum toxin; skin quality; lower third of the face; neck; platysma.

  • Keywords: microbotox; botulinum toxin; skin quality; lower third of the face; neck; platysma.

  • Abstract:

    Improving skin quality—including texture, micro-relief, sheen, visible pores, oiliness, and visual uniformity—has become a central therapeutic goal in cosmetic dermatology, especially in the lower third of the face and neck, regions with high anatomical complexity and functional risk in case of improper diffusion of botulinum toxin (BRANDT; BOKER, 2003; JABBOUR et al., 2017; YOUN et al., 2022). Microbotox (intradermal microdroplets of botulinum toxin type A) has been proposed to modulate skin attachments and superficial muscle fibers, aiming at natural skin quality outcomes (WU, 2015; KAUR et al., 2022; KASSIR et al., 2023). This systematic review (with structured narrative synthesis) summarized the mechanisms, technique, efficacy, and safety of intradermal microbotox for skin quality in the lower third and neck. The corpus included nine mandatory audited references, the study detailing dilution/microvolumes in an associated protocol (BERTOSSI et al., 2019), and four additional audited references that expand the evidence base for quantitative skin improvement, lifting effect, oiliness, and erythema (DIASPRO et al., 2020; NG; LELLOUCH, 2022; ROSE; GOLDBERG, 2013; YEH;
    SHIH; HUANG, 2025). The findings support biological plausibility and clinical evidence for improved texture/sheen and smoothing of superficial cervical changes, as well as indirect benefits in soft tissue contour and ptosis when the application remains superficial (WU, 2015; AWAIDA et al., 2018; KASSIR et al., 2023; NG; LELLOUCH,
    2022). Safety critically depends on the intradermal plane, microvolumes, patient selection, and anatomical mastery, especially of the platysma and perioral regions (BRANDT; BOKER, 2003; AWAIDA et al., 2018; YOUN et al., 2022).

  • André Luiz Menezes Cidrão
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