Paradoxical bulging of mentalis after botulinum toxin type A injection

Yu, Nanze; Liu, Yutong; Chen, Cheng; Dong, Ruijia; Yang, Elan; Wang, Xiaojun

doi:10.1111/jocd.13437

Cited by 7 publications

(11 citation statements)

References 11 publications

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“…Lower facial muscles intermingle with each other and are duplicated on either side of the face; therefore, BoNT diffusion should be carefully considered during injection procedures. Yu et al [37] reported a patient who received BoNT injection in the mentalis muscle, which caused paradoxical bulging. The authors speculate that, when the injection of BoNT fully covers the whole thickness of the muscle, paradoxical bulging may occur.…”

Section: Discussionmentioning

confidence: 99%

Novel anatomical guidelines for botulinum neurotoxin injection in the mentalis muscle: a review

Lee

et al. 2023

Anat Cell Biol

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The mentalis muscle is a paired muscle originating from the alveolar bone of the mandible. This muscle is the main target muscle for botulinum neurotoxin (BoNT) injection therapy, which aims to treat cobblestone chin caused by mentalis hyperactivity. However, a lack of knowledge on the anatomy of the mentalis muscle and the properties of BoNT can lead to side effects, such as mouth closure insufficiency and smile asymmetry due to ptosis of the lower lip after BoNT injection procedures. Therefore, we have reviewed the anatomical properties associated with BoNT injection into the mentalis muscle. An up-to-date understanding of the localization of the BoNT injection point according to mandibular anatomy leads to better injection localization into the mentalis muscle. Optimal injection sites have been provided for the mentalis muscle and a proper injection technique has been described. We have suggested optimal injection sites based on the external anatomical landmarks of the mandible. The aim of these guidelines is to maximize the effects of BoNT therapy by minimizing the deleterious effects, which can be very useful in clinical settings.

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Section: Discussionmentioning

confidence: 99%

Novel anatomical guidelines for botulinum neurotoxin injection in the mentalis muscle: a review

Lee

et al. 2023

Anat Cell Biol

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“…The MM is cone-shaped, originating in the incisor fossa and inserting into the skin of the chin. 4,5 DAO originates at the base of the mandible and inserts into modiolus, being the most superficial and lateral muscle of the set. DLI also originates at the base of the mandible, superior, and medially to the origin of the DAO, with its insertion in the lower lip.…”

Section: Discussionmentioning

confidence: 99%

“…OO is inserted superficially in the skin and mucosa of the lips around the oral rhyme. The MM is cone‐shaped, originating in the incisor fossa and inserting into the skin of the chin 4,5 . DAO originates at the base of the mandible and inserts into modiolus, being the most superficial and lateral muscle of the set.…”

Section: Discussionmentioning

confidence: 99%

An unusual adverse event of botulinum toxin injection in the lower face

Souto

2020

J of Cosmetic Dermatology

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The injection of botulinum toxin A (BoNTA) is one of the most used cosmetic procedures for the treatment of dynamic facial wrinkles.The low rate of side effects and the great satisfaction of the patient with the results contribute to the increasing popularity of this procedure. 1 Botulinum toxin A is traditionally used on the upper third of the face to reduce wrinkles and improve eyebrow positioning. Currently, there is a tendency to apply BoNTA all over the face and neck, in order to improve facial contour, marionette lines and chin wrinkles.The anatomical complexity of the lower third of the face requires a more precise application of BoNTA and unexpected effects of migration of this toxin may occur. This paper reports a case of asymmetry

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“…Furthermore, few studies have investigated the dynamic analyses of the formation of crow's feet, including detailed anatomical investigation of the orbital portion of the orbicularis oculi muscle via ultrasonography, to date. Several attempts have been made to utilize ultrasonography in guided injections in the musculoskeletal areas 4,5 . A previous study comparing conventional blind injection and ultrasonography‐guided BoNT injection found that ultrasonography‐guided injection successfully increased the safety and reliability during the procedure.…”

Section: Introductionmentioning

confidence: 99%

“…Several attempts have been made to utilize ultrasonography in guided injections in the musculoskeletal areas. 4,5 A previous study comparing conventional blind injection and ultrasonography-guided BoNT injection found that ultrasonography-guided injection successfully increased the safety and reliability during the procedure. When using ultrasonography, clinicians can precisely confirm the target muscle and needle position to avoid complications.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic analyses of Crow's feet and novel guideline for botulinum toxin injection

Piao

Choi

et al. 2022

J of Cosmetic Dermatology

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Background Crow's feet are bilateral orbital wrinkles formed by the orbital portion of the orbicularis oculi muscle, which is the target muscle for botulinum neurotoxin (BoNT) injection. Objectives This study's aim was to demonstrate a novel BoNT injection guideline by assessing muscle width, thickness, and dynamic features using ultrasonography. Methods Twenty healthy Korean volunteers (10 men, 10 women; mean age, 25.6) participated. The width, thickness, and dynamic movement of the orbicularis oculi muscle were measured using ultrasonography. Two volunteers were selected to receive BoNT injections. Injections were administered using a novel method with two curved reference lines passing a point 15 mm lateral to the lateral canthus (conventional injection) and a point 5 mm lateral to the lateral margin of the frontal process of zygomatic bone (additional injection). Result At the lateral canthus level, the distance between the lateral margin of the frontal process and the most lateral margin of the orbicularis oculi muscle was 12.5 ± 1.3 mm. The thickness of the orbicularis oculi muscle at the midpoint of the frontal process, the lateral marginal of the frontal process, and 5 mm lateral to the lateral marginal of the frontal process was 0.7 ± 0.3 mm, 1.1 ± 0.3 mm, and 1.2 ± 0.3 mm, respectively. The crow's feet of the two volunteers began to disappear from day 3 and completely disappeared on day 7 after the injection. Conclusion The novel injection technique based on the ultrasonographic anatomy resulted in improvements in the appearance of crow's feet.

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Paradoxical bulging of mentalis after botulinum toxin type A injection

Cited by 7 publications

References 11 publications

Novel anatomical guidelines for botulinum neurotoxin injection in the mentalis muscle: a review

Novel anatomical guidelines for botulinum neurotoxin injection in the mentalis muscle: a review

An unusual adverse event of botulinum toxin injection in the lower face

Ultrasonographic analyses of Crow's feet and novel guideline for botulinum toxin injection

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