Relationship between forehead motion and the shape of forehead lines—A 3D skin displacement vector analysis

Abstract

Objective: Neuromodulator injections of the forehead are often performed using standardized protocols. This study was designed to identify the individual skin motion pattern of the forehead and to relate this pattern to the underlying frontalis muscle morphology to offer guidance for neuromodulator placement.

To click or not to click – The importance of understanding the layers of the forehead when injecting neuromodulators – A clinical, prospective, interventional, split‐face study

“…12 This fascia connects the frontalis muscle via thin septae also termed retinacula cutis to the frontal skin underside and is responsible for the direct force transmission between the moving muscle and the overlying skin 13 ; this enables the overlying skin to reflect directly on the contraction pattern and on the level of contractility of the underlying muscle. 8,9 Positioning the product superficial to the suprafrontalis fascia and into the su- Clinically, the results of this and previous split-face studies indicate that the effectiveness of forehead neuromodulator injections depends highly on the depth of product administration. 6,7 The same amount of neurotoxin in the same anatomic location (forehead) can have different effects when injected superficially or deep.…”

“…The Fitzpatrick skin types of the included study participants were: Type 1 n = 3 (21.4%), Type 2 n = 4 (28.6%), and Type 3 n = 7 (50.0%); the type of horizontal forehead lines was wavy in n = 9 (64.3%) and straight in n = 5 (35.7%). 8,9 Inclusion criteria were no neuromodulator injections of the upper face within 6 months prior, no previous soft tissue filler administration (any type) to the forehead and no history of trauma or surgical procedure of their forehead that could have resulted in a disruption of a normal muscular and fascial frontal anatomy, and no grossly visible asymmetry at rest or at maximal frontalis contraction.…”

Clinical validation of the temporal lifting technique using soft tissue fillers

“…For comparison purposes, the ICC of the three‐month outcome rating performed by the patient and treating physician was 0.317 indicating poor consistency. Results from 3D imaging might provide valuable insight into theoretical basic tissue biomechanics; this imaging technique was utilized previously in a plethora of cadaveric studies 4,13‐15 . However, the major drawback is the clinical relevance of the changes measured, as the calculated changes might be statistically significant in a theoretical (=cadaveric) model but it is unclear whether one can extrapolate these results to the in vivo clinical setting; this was the primary reason to expand the evaluation to objective nonesthetic raters.…”

The Influence of the Insertion Angle on Middle and Lower Face Tissue-Mechanics When Treating the Nasolabial Folds with Facial Suspension Threads—An Experimental Split-Face Cadaveric Study

“…Image analysis was conducted as described previously. [21][22][23] Three-dimensional (3D) images of the faces were taken by toward a better aesthetic outcome when utilizing long facial suspension threads that can effect full-face changes as compared with short facial suspension threads.…”