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Characterizing the Lateral Border of the Frontalis for Safe and Effective Injection of Botulinum Toxin

 You-Jin Choi  ;  Sung-Yoon Won  ;  Jae-Gi Lee  ;  Kyung-Seok Hu  ;  Sung-Taek Kim  ;  Tanvaa Tansatit  ;  Hee-Jin Kim 
 AESTHETIC SURGERY JOURNAL, Vol.36(3) : 344-348, 2016 
Journal Title
Issue Date
Acetylcholine Release Inhibitors/administration & dosage* ; Aged ; Aged, 80 and over ; Anatomic Landmarks* ; Botulinum Toxins, Type A/administration & dosage* ; Cadaver ; Cosmetic Techniques* ; Facial Muscles/anatomy & histology* ; Female ; Forehead/anatomy & histology* ; Humans ; Injections, Intramuscular ; Male ; Middle Aged ; Rejuvenation* ; Republic of Korea
BACKGROUND: The forehead is a common site for injection of botulinum neurotoxin type A (BoNT-A) to treat hyperactive facial muscles. Unexpected side effects of BoNT-A injection may occur because the anatomy of the forehead musculature is not fully characterized. OBJECTIVES: The authors described the lateral border of the frontalis in terms of facial landmarks and reference lines to determine the safest and most effective forehead injection sites for BoNT-A. METHODS: The hemifaces of 49 embalmed adult Korean cadavers were dissected in a morphometric analysis of the frontalis. L2 was defined in terms of FT (the most protruding point of the frontotemporal region), L0 (the line connecting the infraorbital margin with the tragus), and L1 (the line parallel to L0 and passing through FT) such that L2 was positioned 45° from L1 and passed through FT. RESULTS: The distance from FT to the superior margin of the orbicularis oculi was 12.3 ± 3.3 mm. The frontalis extended more than 5 cm along L2 in 49 of 49 cases (100%), more than 6 cm in 47 cases (95.9%), more than 7 cm in 34 cases (69.4%), more than 8 cm in 11 cases (22.4%), and more than 9 cm in 3 cases (6.1%). The lateral border of the frontalis ran parallel to and within 1 cm of the medial side of L2. CONCLUSIONS: Surface anatomy mapping can assist with predicting the lateral border of the frontalis to minimize the side effects and maximize the efficiency of BoNT-A injections into the forehead.
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2. College of Dentistry (치과대학) > Dept. of Orofacial Pain and Oral Medicine (구강내과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral Biology (구강생물학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seong Taek(김성택)
Kim, Hee Jin(김희진) ORCID logo https://orcid.org/0000-0002-1139-6261
Choi, You Jin(최유진) ORCID logo https://orcid.org/0000-0003-3701-2200
Hu, Kyung Seok(허경석) ORCID logo https://orcid.org/0000-0002-9048-3805
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