Evidence map›Paper›PMID 41277724›Full record

ArticleJournal of cosmetic dermatology2025

Accessing the Levator Labii Superioris Alaeque Nasi (LLSAN) Muscle for the Treatment of Infraorbital Dimples-A Case Report.

Sergio Escobar, Maria Victoria Silva Oliveira, Mariana Calomeni, Carlos Bravo, Paula Arroyo, Pamela Saavedra, Sebastian Cotofana, Michael Alfertshofer

Abstract readCase Reports
In one paragraph

Article in Journal of cosmetic dermatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sergio EscobarPrivate Practice, Buenos Aires, Argentina.
Maria Victoria Silva OliveiraPrivate Practice, Buenos Aires, Argentina.
Mariana CalomeniClinica Bravo, Rio de Janeiro, Brazil.
Carlos BravoPrivate Practice, San José, Costa Rica.
Paula ArroyoPrivate Practice, Santiago, Chile.
Pamela SaavedraPrivate Practice, Santiago, Chile.
Sebastian CotofanaDepartment of Dermatology, Erasmus Medical Centre, Rotterdam, the Netherlands.ORCID https://orcid.org/0000-0001-7210-6566
Michael AlfertshoferDepartment of Oral and Maxillofacial Surgery, Charité University Hospital Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-4892-2376

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMedial infraorbital dimples are dynamic soft tissue depressions that can emerge or intensify following neuromodulator treatment in the periorbital region. Rather than being congenital or structural in origin, these dimples often result from imbalanced facial muscles most notably the levator labii superioris alaeque nasi (LLSAN).

objectiveTo elucidate the pathophysiology of a medial infraorbital dimple arising after botulinum toxin injection into the lateral orbicularis oculi muscle (OOM) and to demonstrate the clinical efficacy of a targeted neuromodulator injection into the LLSAN muscle. CASE SUMMARY: We present a case involving a 31-year-old female who developed a prominent medial infraorbital dimple four weeks after receiving a cosmetic botulinum toxin injection for her crow's feet. This dimple was most prominent during smiling. A single, superficial injection of 2 units of botulinum toxin type A into the LLSAN led to substantial aesthetic improvement, starting 2 days after the treatment with preserved natural expression and no functional deficit.

conclusionRecognition of compensatory muscular activity and intramuscular injection of neuromodulators for the LLSAN offers a safe and effective approach for treating medial infraorbital dimples while preserving facial harmony.

Indexed as

Botulinum Toxins, Type ACosmetic TechniquesFacial MusclesNeuromuscular AgentsAdultFemaleHumansInjections, IntramuscularSmilingTreatment OutcomeBotulinum Toxins, Type ANeuromuscular Agentsfacial aestheticsfacial anatomyinfraorbital dimpleLLSAN musclemuscular balance

Identifiers

PMID41277724
PMCPMC12641590

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