Increasing precision during neuromodulator injections for frontal rhytids-Using ultrasound imaging to identify the line of convergence.

Autor: Meneses CCB; Private Practice, São Paulo, Brazil., Freitas S; Sially Institute, São Paulo, Brazil., Knoedler L; Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA., Knoedler S; Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Davidovic K; Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, Belgrade, Serbia., Bravo C; Private Practice, San José, Costa Rica., Pappas A; Evolus Inc., Newport Beach, California, USA., Biesman BS; Private Practice, Nashville, Tennessee, USA., Alfertshofer M; Department of Oromaxillofacial Surgery, University Hospital, LMU Munich, Munich, Germany., Cotofana S; Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands.; Centre for Cutaneous Research, Blizard Institute, Queen Mary University of London, London, UK.; Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong Province, China.
Jazyk: angličtina
Zdroj: Journal of cosmetic dermatology [J Cosmet Dermatol] 2024 Jul; Vol. 23 (7), pp. 2373-2379. Date of Electronic Publication: 2024 May 16.
DOI: 10.1111/jocd.16368
Abstrakt: Background: Recent research introduced the concept of the "line of convergence" as a guide for injectors to enhance precision and avoid complications when treating the frontalis muscle with toxins. However, currently, no pre-injection ultrasound scanning is employed to increase precision and reduce adverse events when searching for the line of convergence.
Objective: To explore the feasibility and practicality of implementing pre-injection ultrasound scanning into aesthetic neuromodulator treatments of the forehead.
Methods: The sample of this study consisted of n = 55 volunteers (42 females and 13 males), with a mean age of 42.24 (10.3) years and a mean BMI of 25.07 (4.0) kg/m 2 . High-frequency ultrasound imaging was utilized to measure the thickness, length, and contractility of the frontal soft tissue and to determine the precise location of the line of convergence during maximal frontalis muscle contraction.
Results: The results revealed that the line of convergence was located at 58.43% (8.7) of the total forehead height above the superior border of the eyebrow cilia without a statistically significant difference between sex, age, or BMI. With frontalis muscle contraction, the forehead shortens in males by 25.90% (6.5), whereas in females it shortens only by 21.74% (5.1), with p < 0.001 for sex differences.
Conclusion: This study demonstrated the feasibility and practicality of pre-injection ultrasound scanning for facial aesthetic neuromodulator treatments. Knowing the location of the line of convergence, injectors can determine precisely and on an individual basis where to administer the neuromodulator deep or superficial or when the injection location is at risk to cause eyebrow ptosis.
(© 2024 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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