Protocol of BTA application.

Table 1: Protocol of BTA application.

1.	Hygiene of the face with 70% alcohol - A cotton soaked in alcohol 70% was used for skin cleansing.
2.	Markings of the injection points with white pencil (Vult®) or similar (Figure 3).The Point was considered 2 mm lateral to the alar-facial groove at the level of the nasal passage, at both sides, to relax the Levator labii superioris alaeque nasi (LLSAN) muscle.
3.	A bottle of 100 units (U) Botulinum Toxin type A (Botox®) was diluted with the aid of a 3 ml syringe together with a disposable 22 G1 hypodermic needle in 1ml of 0.9% saline sterile solution immediately before injection, following the recommendation guidelines on dilution and storage.
4.	Prior to injection, the region was cooled with ice for 5 seconds to promote temporary analgesia.
5.	It was applied 2 U of BTA in each point in the subcutaneous tissue through a BD Insulin syringe ultra-fine TM (BM Medical - Diabetes Care, Holdrege, USA) 30 U. with 8 mm × 30 G needle.
6.	Patient was instructed with the recommendation: To maintain elevated head for 4 h; do not compress the region; not performing physical activities for 24 hours.
7.	Photographs of the final result were taken 20 days after the injection.