Subscribe to RSS
DOI: 10.1055/a-2338-0581
Investigating Facial Muscle Physiology Following Soft Tissue Filler Injections—A Surface-derived Electromyographic and Skin Vector Displacement Analytic Study
![](https://www.thieme-connect.de/media/fps/EFirst/lookinside/thumbnails/10-1055-a-2338-0581_2023060111or-1.jpg)
Abstract
The use of hyaluronic acid-based soft tissue fillers has often been reported to modulate the muscle, that is, to cause myomodulation. To our knowledge, there has been so far no scientific study investigating the potential of hyaluronic acid-based soft tissue fillers to modulate or actually alter the function of facial muscles. To further assess this three-dimensional (3D) surface imaging and electromyography (EMG)-based prospective study investigated the changes of facial muscle contraction after injection of strategically placed hyaluronic acid-based soft tissue fillers to assess the actual validity of the term myomodulation. A total of 13 subjects with a mean age of 37.8 years (12 females, 1 male) were injected according to a predefined injection protocol. Surface EMG and 3D surface imaging were performed prior to the injection and 5 days after the injection. The results showed no significant change in the strength of the muscles (measured in μV) after injection of hyaluronic acid-based soft tissue fillers. However, horizontal and vertical skin displacement upon contraction of the zygomaticus major muscle changed significantly between baseline and follow-up, with a mean horizontal skin displacement increase from 3.2 to 4.1 mm. Upon contraction of the depressor anguli oris muscle, the horizontal skin displacement did not change significantly (2.15 vs. 2.05 mm), while vertical skin displacement increased significantly from 2.9 to 4.3 mm. The modification of the surrounding tissue caused an alteration of the vectorial skin displacement upon contraction of the muscle. A potential explanation could be the increased distance between the origin and insertion of the muscle due to the material deposition in the proximity of the relevant facial muscles, leading to a change of contraction vector.
Publication History
Accepted Manuscript online:
04 June 2024
Article published online:
15 July 2024
© 2024. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 The Aesthetic Society. Aesthetic Plastic Surgery National Databank Statistics 2020–2021. Aesthet Surg J 2022; 42 (Suppl. 01) 1-18
- 2 de Melo F, Nicolau P, Piovano L. et al. Recommendations for volume augmentation and rejuvenation of the face and hands with the new generation polycaprolactone-based collagen stimulator (Ellansé®). Clin Cosmet Investig Dermatol 2017; 10: 431-440
- 3 Cassuto D, Bellia G, Schiraldi C. An overview of soft tissue fillers for cosmetic dermatology: from filling to regenerative medicine. Clin Cosmet Investig Dermatol 2021; 14: 1857-1866
- 4 Rohrich RJ, Ghavami A, Crosby MA. The role of hyaluronic acid fillers (Restylane) in facial cosmetic surgery: review and technical considerations. Plast Reconstr Surg 2007; 120 (06) 41S-54S
- 5 Farolch-Prats L, Nome-Chamorro C. Facial contouring by using dermal fillers and botulinum toxin a: a practical approach. Aesthetic Plast Surg 2019; 43 (03) 793-802
- 6 Hernandez CA, Freytag DL, Gold MH. et al. Clinical validation of the temporal lifting technique using soft tissue fillers. J Cosmet Dermatol 2020; 19 (10) 2529-2535
- 7 Hernandez CA, Schneider C, Gold D MH. et al. After the temporal lifting technique-what comes next?. J Cosmet Dermatol 2021; 20 (12) 3857-3862
- 8 de Maio M. Myomodulation with injectable fillers: an innovative approach to addressing facial muscle movement. Aesthetic Plast Surg 2018; 42 (03) 798-814
- 9 Coimbra DDA, Stefanello B. Myomodulation with facial fillers: a comprehensive technical guide and retrospective case series. Aesthetic Plast Surg 2023; 47 (03) 1162-1174
- 10 de Maio M. Myomodulation with injectable fillers: an update. Aesthetic Plast Surg 2020; 44 (04) 1317-1319
- 11 Frank K, Moellhoff N, Kaiser A. et al. Signal-to-noise ratio calculations to validate sensor positioning for facial muscle assessment using noninvasive facial electromyography. Facial Plast Surg 2021; 37 (05) 614-624
- 12 Frank K, Assemi-Kabir S, Alfertshofer MG. et al. Electrophysiologic frontalis muscle response following neuromodulator injections. Facial Plast Surg Clin North Am 2022; 30 (02) 225-231
- 13 Li H, Zhao G, Zhou Y, Chen X, Ji Z, Wang L. Relationship of EMG/SMG features and muscle strength level: an exploratory study on tibialis anterior muscles during plantar-flexion among hemiplegia patients. Biomed Eng Online 2014; 13: 5