Understanding Facial Muscle Aging: A Surface Electromyography Study

Cotofana, Sebastian; Assemi-Kabir, Shirin; Mardini, Samir; Giunta, Riccardo E.; Gotkin, Robert H; Moellhoff, Nicholas; Avelar, Luiz Eduardo Toledo; Mercado‐Perez, Arnaldo; Lorenc, Z. Paul; Frank, Konstantin

doi:10.1093/asj/sjab202

Cited by 26 publications

(13 citation statements)

References 23 publications

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“… 17-19 Changes in the facial muscle could also been demonstrated in recently published in vivo electromyography investigations. 7 This could potentially explain the slightly better outcome in females aged 35 to 50 years, as elderly patients might require a higher dosage due to the aforementioned age-dependent processes at the neuromuscular junction. This subanalysis has shown that in the most frequently targeted patient group, facing a certain degree of aging that can be considered mid-aged, 20 U of letibotulinumtoxinA, spread over 5 injection points offers high efficacy with minimal complication rates.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of LetibotulinumtoxinA in the Treatment of Moderate and Severe Glabellar Lines in Females 35 to 50 Years of Age: Post Hoc Analyses of the Phase 3 Clinical Study Data

Gold,

Taylor,

Mueller

et al. 2024

Aesthetic Surgery Journal Open Forum

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Background Botulinum toxin (BoNT-A) injections continue to be widely used as a common treatment for both men and women. According to a recent survey conducted by the International Society of Plastic Aesthetic Surgeons (ISAPS), the majority of patients receiving these injections are females between the ages of 35 and 50. Objectives A post-hoc analysis was conducted to examine whether there were variances in the effectiveness and safety of letibotulinumtoxinA for treating vertical glabellar lines between the broader female study population and a particularly defined group of female participants aged 35 to 50. Methods For this post – hoc analysis data from females aged 35–50 were extracted and analysed from the BLESS III study. In this Phase 3 clinical trial, 355 participants with moderate to severe glabella frown lines received either 20 U of letibotulinumtoxinA or a placebo. The study evaluated GLS score, treatment onset, duration of effects, time to retreatment, and adverse events. A positive response was determined by achieving a GLS score of 0 or 1, as assessed by both subjects and investigators, along with at least a 2-point improvement in GLS score relative to baseline at Week 4 after the injections. Results Composite responder rates for subjects aged 35-50 receiving active treatment were significantly higher than for the remaining female population receiving active treatment at weeks 1, 2, and 4. Females aged 35-50 showed higher rates of GLS improvement of ≥1 at weeks 1, 2, 4, 8, 12, 16, and 20 compared to the remaining female population receiving active treatment. At week 4, a higher percentage of females aged 35-50 achieved a GLS score of 0 upon maximum frowning compared to the remaining females. Females aged 35-50 had a shorter median time to onset of GLS improvement compared to the remaining female population. Safety assessment showed a low incidence of treatment-related adverse events in females aged 35-50. Conclusions LetibotulinumtoxinA showed significantly higher response rates in females aged 35-50 compared to other female subjects at weeks 1, 2, and 4. Response rates remained higher up to week 16. The treatment demonstrated efficacy and safety in treating vertical glabellar lines in this patient group.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of LetibotulinumtoxinA in the Treatment of Moderate and Severe Glabellar Lines in Females 35 to 50 Years of Age: Post Hoc Analyses of the Phase 3 Clinical Study Data

Gold,

Taylor,

Mueller

et al. 2024

Aesthetic Surgery Journal Open Forum

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“…Although the following procedures were not performed in this study, transplanting fat near the malar fat pad is helpful for rejuvenation, as the SMAS thins out after the zygomaticus major muscle is visible. 23,24 In general, Asian patients have larger faces than White patients and have protruding malar eminences. 26 Thus, as the force pulling the flap in front of the tragus is difficult to transmit to the fat in the medial NLF, the same improvement effects are not observed in Asian patients as in White patients.…”

Section: Discussionmentioning

confidence: 99%

Modified Deep-Plane Face Lift and Lower Midface Lifting Using Deep Fat Compartment Mobilization and Zygomaticus Major Muscle Plication

Kim¹,

Choi

Chung

2023

Plastic &Amp; Reconstructive Surgery

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Facial aging is caused by various factors. Radiation exposure, gravity, smoking, and hormonal changes lead to structural changes, including decreased skin elasticity, subcutaneous fat malposition, muscle aging, retention of ligament attenuation, and bone changes, leading to facial aging. 1,2 In the modern clinical setting, relatively noninvasive procedures, such as carbon dioxide laser resurfacing, and other invasive procedures, including face-lift surgery, are used to treat facial aging. 3 Traditionally, the face-lift technique involves stretching the loose facial skin. However, this technique was limited in terms of producing longlasting surgical results. In 1974, Skoog proposed a method of relocating subcutaneous fat and platysma muscles to improve facial aging by manipulating all of the soft tissue and skin. 4 Subsequently, Mitz and Peyronie introduced the superficial musculoaponeurotic system (SMAS), and various surgical methods that enable SMAS manipulation, such as SMAS plication and SMASectomy, Background: Most face-lift techniques greatly improve the lower face; however, techniques for lifting the midface are limited and difficult. Original deep-plane face lift is a way to lift the superficial musculoaponeurotic system and skin as a compound unit. Although it minimizes tear of the superficial musculoaponeurotic system during dissection, damage to the vascular system, and the incidence of skin necrosis, and can be easily used in secondary cases, the deep-plane face lift does not adequately improve nasolabial fold. The authors perform a modified and enhanced deep-plane face lift to improve the midface. In this article, the authors explain the effects and procedures of the method. Methods: This retrospective study included patients (n = 632) on whom deepplane face lift (DPF group; n = 299) and modified deep-plane face lift (M-DPF group; n = 333) was performed by a single surgeon from January of 2014 to January of 2017, and from February of 2017 to December of 2020, respectively, at a local clinic. The degree of improvement in wrinkles in the patients' nasolabial fold was assessed using the five-grade Wrinkle Severity Rating Scale (WSRS). Results: The preoperative WSRS score was 2.95 ± 0.89 in the DPF group and 2.89 ± 0.92 in the M-DPF group. There was no significant difference in the preoperative WSRS score between the two groups (P = 0.058). The postoperative WSRS score was 1.81 ± 0.68 in the DPF group, which was significantly greater than the 1.65 ± 0.66 found in the M-DPF group. Conclusion: This method developed by the authors that combines deep-plane face lift with deep fat compartment mobilization and zygomaticus major muscle plication is safe and directly improves the nasolabial fold and promotes a smiling expression for rejuvenation effects.

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“…This facilitates the age-related transition from dynamic to static lines. Thus, providing early injection of neuromodulators may decrease the severity of a patient's static frown lines or even prevent their formation (Cotofana et al, 2021).…”

Section: Suggested Injection Techniquementioning

confidence: 99%

Vascular Safe Zones for Facial Soft Tissue Filler Injections

Cotofana¹,

Lowrey²,

Frank³

et al. 2022

Plastic and Aesthetic Nursing

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The number of soft tissue filler injections performed by aesthetic injectors has continued to increase over the last few years. To provide a high standard of safety and achieve individualized, reproducible, and long-lasting outcomes, aesthetic injectors must have a solid foundation in anatomy, facial biomechanics, rheology, and injection biomechanics. Adverse events associated with soft tissue filler injections can be severe, especially if the aesthetic injector unintentionally injects the soft tissue filler into the patient's arterial vascular circulation and the administered product reaches the arterial bloodstream. Although the face has a rich arterial vascular supply that may seem overwhelmingly complex, it can be broken down systematically according to its internal and external vascular territories. To provide guidance for aesthetic practitioners performing minimally invasive facial injections for aesthetic purposes, this narrative article will discuss the course, depth, and branching pattern of the facial arteries based on the most frequently injected anatomical regions. In this article, we focus on vascular safe zones rather than danger zones.

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Understanding Facial Muscle Aging: A Surface Electromyography Study

Cited by 26 publications

References 23 publications

Efficacy and Safety of LetibotulinumtoxinA in the Treatment of Moderate and Severe Glabellar Lines in Females 35 to 50 Years of Age: Post Hoc Analyses of the Phase 3 Clinical Study Data

Efficacy and Safety of LetibotulinumtoxinA in the Treatment of Moderate and Severe Glabellar Lines in Females 35 to 50 Years of Age: Post Hoc Analyses of the Phase 3 Clinical Study Data

Modified Deep-Plane Face Lift and Lower Midface Lifting Using Deep Fat Compartment Mobilization and Zygomaticus Major Muscle Plication

Vascular Safe Zones for Facial Soft Tissue Filler Injections

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