ArticleAesthetic surgery journal2025
Exploratory Analysis of Upper Facial Muscle Interplay During Emotional Expressions: Magnetic Resonance Imaging (MRI) Insights From Young, Caucasian, Toxin-naïve Individuals.
Article in Aesthetic surgery journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Advancing the Evidence on Glabellar Contraction Patterns-A Prospective Multicenter Study on Its Clinical Relevance for Glabellar Neuromodulator Injections.Journal of cosmetic dermatology · 2026Trial
- Commentary on: The Facial Muscle Chain Concept in Forehead Line Treatment.Aesthetic plastic surgery · 2026Article
- Continuous Improvement of Frontal Rhytids Following Glabella Only Treatments With Neuromodulators-A Clinical Prospective Pilot Study.Journal of cosmetic dermatology · 2025Article
- Real-World Outcomes of a Novel Botulinum Toxin A for Upper Face Aesthetics: Insights From Routine Clinical Practice.Aesthetic surgery journal. Open forum · 2025Article
Corrections and comments
- Comment onCommentary on: The Facial Muscle Chain Concept in Forehead Line Treatment.2026 · No abstract available
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnderstanding the interplay of muscle activity in the upper face is crucial because it can significantly impact the effectiveness and safety of aesthetic treatments. Traditional injection algorithms typically focus on the general 2-dimensional and 3-dimensional anatomy of muscles, often neglecting the areas where muscles exert the greatest force during facial expressions.
objectivesThe goal of this study was to analyze the location of greatest morphological change in the upper facial muscles including the procerus muscle (PM), corrugator supercilii muscle (CSM), orbicularis oculi muscle (OOM), and frontalis muscle (FM) during various facial expressions.
methodsA total of 34 healthy young individuals (17 females, 17 males), with a mean age of 23.6 ± 2.4 years [range 20-30], were examined with magnetic resonance imaging (MRI) to assess the length, thickness, and width of the upper facial muscles (PM, CSM, OOM, and FM) for 5 different facial expressions: repose, anger, joy, surprise, and sadness.
resultsFacial muscle thickness is a key indicator of activity during expressions such as anger, joy, surprise, and sadness. During anger, the PM and CSM decreased in length and width but increased in thickness, whereas the FM passively contracted to stabilize the expression. The OOM showed increased thickness in its medial, inferior, lateral, and superior portions during various expressions, with specific regions activating differently depending on the expression, such as the medial and lateral parts during surprise and the inferior and lateral parts during joy. The medial third of the CSM was the most active region during contraction.
conclusionsUpper facial muscles-as either agonists or antagonists-act together during facial expressions to stabilize facial expressions, emphasizing the need to assess both groups in neuromodulator treatments. The medial third of the corrugator supercilii shows the most significant MRI changes, making it the primary target for injections. LEVEL OF EVIDENCE: 4 (THERAPEUTIC):
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