MRI Study updates approach to Glabellar Rhytid treatments

Image from shutterstock

A new study led by Professor Sebastian Cotofana and the Harley Academy Research Group, published in the Aesthetic Surgery Journal (October 2024), challenges long-standing practices in the treatment of glabellar lines with neuromodulators. This research sheds fresh light on the anatomical basis of contraction patterns and their clinical significance, offering a clearer path forward for practitioners.

Historical discussions about glabellar lines trace back to Charles Darwin, who observed a distinct forehead crease, termed the "omega melancholicum," in individuals displaying melancholia. Over a century later, the connection between facial expressions and muscle activity was scientifically validated. In the early 2010s, a Brazilian research team suggested tailoring glabellar treatments based on five distinct contraction patterns visible when patients frowned. Their hypothesis challenged standard protocols, proposing customised injection strategies to enhance outcomes and reduce complications.

To investigate this theory, researchers from the Jagiellonian University Medical College in Kraków conducted a comprehensive MRI-based study on young, toxin-naïve participants. Subjects were grouped according to the five previously defined glabellar contraction patterns. Detailed imaging analyses assessed parameters such as muscle thickness, length, and surface area of the corrugator supercilii, procerus, frontalis, and orbicularis oculi muscles.

The results showed no significant anatomical differences in muscle structure between the contraction pattern groups. This finding indicates that contraction patterns do not necessitate variations in injection site or depth during neuromodulator treatments.

The study reaffirms the efficacy of the standard injection protocol for neuromodulators in the glabellar region, suggesting that the placement of injections can remain consistent across patients. Minor adjustments in dosage may still be required to account for individual variability, but the research debunks the need for pattern-specific strategies, a concept that has influenced practices for over a decade.

By simplifying treatment approaches, these findings reduce the likelihood of suboptimal results and adverse effects. Further research will be needed to broaden the understanding of glabellar anatomy in aesthetics.