A Refined Injection Strategy for the Upper Third Using Incobotulinum Toxin A to Enhance Facial Harmony and Preserve Natural Expression.

The eyebrow is a central anatomical unit in upper facial aesthetics, where multiple muscle groups-including the frontalis, corrugator supercilii, and orbicularis oculi-interact to influence its position and movement. Achieving an optimal balance among these muscles is crucial to enhance facial harmony while preserving natural expressiveness. This study describes an anatomy-based injection strategy using hyperdiluted incobotulinum toxin A, administered through a higher number of injection sites for each muscle in the upper third of the face. Compared with conventional methods using fewer, more concentrated injection points, this approach is intended to promote more uniform toxin distribution, minimise untreated areas, reduce the occurrence of compensatory wrinkles and support balanced neuromodulation while limiting excessive muscle weakening. By integrating microdosing, hyperdilution, and expanded injection mapping, the proposed technique aims to preserve eyebrow dynamics, reduce the risk of brow ptosis, and achieve a more natural aesthetic outcome. The approach is compared with conventional injection patterns, highlighting differences in dose distribution, injection depth, and muscle targeting. Two clinical cases illustrate the feasibility and potential clinical utility of the proposed approach as a refined and customisable strategy for upper facial rejuvenation.