Pivotal role of injection volume on sunken cheek prevention in masseter muscle BoNT‐A injection: A cadaver study

Background Botulinum neurotoxin A injection is a popular noninvasive alternative for the treatment of masseter hypertrophy. This study was conducted to identify a safe injection volume to avoid sunken lateral cheek after botulinum neurotoxin A injection in the masseter muscle. Methods One milliliter...

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Veröffentlicht in:Journal of cosmetic dermatology 2022-01, Vol.21 (1), p.137-141
Hauptverfasser: Yu, Panxi, Zhai, Haixin, Li, Zhijin, Dong, Ruijia, Wu, Tingting, Li, Yunzhu, Di, Zhang, Sun, Yixin, Long, Xiao, Yu, Nanze
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container_end_page 141
container_issue 1
container_start_page 137
container_title Journal of cosmetic dermatology
container_volume 21
creator Yu, Panxi
Zhai, Haixin
Li, Zhijin
Dong, Ruijia
Wu, Tingting
Li, Yunzhu
Di, Zhang
Sun, Yixin
Long, Xiao
Yu, Nanze
description Background Botulinum neurotoxin A injection is a popular noninvasive alternative for the treatment of masseter hypertrophy. This study was conducted to identify a safe injection volume to avoid sunken lateral cheek after botulinum neurotoxin A injection in the masseter muscle. Methods One milliliter or 0.5 ml of indocyanine green was randomly injected into either side of the masseter muscles of 18 fresh cadaver heads. The bilateral spreads of indocyanine green within the masseter were observed by a fluorescence imager. The masseters were then dissected, and the spreading distance was measured. Results Dye spreading showed an oval shape parallel to the long axis of the masseter muscle. The lower edges of the masseters were all stained with indocyanine green. The upward spreading exceeded the mouth corner‐tragus line in 94.44% (17/18) of the masseters on the 1‐ml side, and 11.11% (2/18) of the masseters on the 0.5‐ml side. The spreading area and upward spreading distance on the 1‐ml side (9.95 ± 0.48 cm2, 3.18 ± 0.31 cm) were significantly larger than the 0.5‐ml side (7.13 ± 0.80 cm2, 2.08 ± 0.32 cm). Conclusions The spread of indocyanine green within the masseter occurs in direct proportion to its volume. A bolus of 1 ml easily exceeded the mouth corner‐tragus line and cause sunken cheek.
doi_str_mv 10.1111/jocd.14658
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This study was conducted to identify a safe injection volume to avoid sunken lateral cheek after botulinum neurotoxin A injection in the masseter muscle. Methods One milliliter or 0.5 ml of indocyanine green was randomly injected into either side of the masseter muscles of 18 fresh cadaver heads. The bilateral spreads of indocyanine green within the masseter were observed by a fluorescence imager. The masseters were then dissected, and the spreading distance was measured. Results Dye spreading showed an oval shape parallel to the long axis of the masseter muscle. The lower edges of the masseters were all stained with indocyanine green. The upward spreading exceeded the mouth corner‐tragus line in 94.44% (17/18) of the masseters on the 1‐ml side, and 11.11% (2/18) of the masseters on the 0.5‐ml side. The spreading area and upward spreading distance on the 1‐ml side (9.95 ± 0.48 cm2, 3.18 ± 0.31 cm) were significantly larger than the 0.5‐ml side (7.13 ± 0.80 cm2, 2.08 ± 0.32 cm). Conclusions The spread of indocyanine green within the masseter occurs in direct proportion to its volume. A bolus of 1 ml easily exceeded the mouth corner‐tragus line and cause sunken cheek.</description><identifier>ISSN: 1473-2130</identifier><identifier>EISSN: 1473-2165</identifier><identifier>DOI: 10.1111/jocd.14658</identifier><identifier>PMID: 34897934</identifier><language>eng</language><publisher>England</publisher><subject>botulinum neurotoxin A ; Botulinum Toxins, Type A - therapeutic use ; Cadaver ; cadaver study ; Cheek ; Humans ; Hypertrophy - drug therapy ; indocyanine green ; Injections, Intramuscular ; Masseter Muscle ; masseter muscle hypertrophy ; Neuromuscular Agents - therapeutic use</subject><ispartof>Journal of cosmetic dermatology, 2022-01, Vol.21 (1), p.137-141</ispartof><rights>2021 Wiley Periodicals LLC</rights><rights>2021 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3298-3294e5a260626de9f145032b5644d1254d1fd0e72dfe02d779eb604161c353bc3</citedby><cites>FETCH-LOGICAL-c3298-3294e5a260626de9f145032b5644d1254d1fd0e72dfe02d779eb604161c353bc3</cites><orcidid>0000-0003-1667-7908 ; 0000-0003-0136-2508</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjocd.14658$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjocd.14658$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34897934$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yu, Panxi</creatorcontrib><creatorcontrib>Zhai, Haixin</creatorcontrib><creatorcontrib>Li, Zhijin</creatorcontrib><creatorcontrib>Dong, Ruijia</creatorcontrib><creatorcontrib>Wu, Tingting</creatorcontrib><creatorcontrib>Li, Yunzhu</creatorcontrib><creatorcontrib>Di, Zhang</creatorcontrib><creatorcontrib>Sun, Yixin</creatorcontrib><creatorcontrib>Long, Xiao</creatorcontrib><creatorcontrib>Yu, Nanze</creatorcontrib><title>Pivotal role of injection volume on sunken cheek prevention in masseter muscle BoNT‐A injection: A cadaver study</title><title>Journal of cosmetic dermatology</title><addtitle>J Cosmet Dermatol</addtitle><description>Background Botulinum neurotoxin A injection is a popular noninvasive alternative for the treatment of masseter hypertrophy. This study was conducted to identify a safe injection volume to avoid sunken lateral cheek after botulinum neurotoxin A injection in the masseter muscle. Methods One milliliter or 0.5 ml of indocyanine green was randomly injected into either side of the masseter muscles of 18 fresh cadaver heads. The bilateral spreads of indocyanine green within the masseter were observed by a fluorescence imager. The masseters were then dissected, and the spreading distance was measured. Results Dye spreading showed an oval shape parallel to the long axis of the masseter muscle. The lower edges of the masseters were all stained with indocyanine green. The upward spreading exceeded the mouth corner‐tragus line in 94.44% (17/18) of the masseters on the 1‐ml side, and 11.11% (2/18) of the masseters on the 0.5‐ml side. The spreading area and upward spreading distance on the 1‐ml side (9.95 ± 0.48 cm2, 3.18 ± 0.31 cm) were significantly larger than the 0.5‐ml side (7.13 ± 0.80 cm2, 2.08 ± 0.32 cm). Conclusions The spread of indocyanine green within the masseter occurs in direct proportion to its volume. A bolus of 1 ml easily exceeded the mouth corner‐tragus line and cause sunken cheek.</description><subject>botulinum neurotoxin A</subject><subject>Botulinum Toxins, Type A - therapeutic use</subject><subject>Cadaver</subject><subject>cadaver study</subject><subject>Cheek</subject><subject>Humans</subject><subject>Hypertrophy - drug therapy</subject><subject>indocyanine green</subject><subject>Injections, Intramuscular</subject><subject>Masseter Muscle</subject><subject>masseter muscle hypertrophy</subject><subject>Neuromuscular Agents - therapeutic use</subject><issn>1473-2130</issn><issn>1473-2165</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOwzAQRS0EoqWw4QOQlwgpxc-kYVfKWxVlUdZRak9E2iQudlLUHZ_AN_IluA_KjlncGY2OzuIidEpJl_q5nBqlu1SEsreH2lREPGA0lPu7m5MWOnJuSgiNYioPUYuLXhzFXLSRfckXpk4LbE0B2GQ4r6ag6txUeGGKpvS_CrummkGF1RvADM8tLKBaE3mFy9Q5qMHisnHKG67N8_j786v_57nCfaxSnS485OpGL4_RQZYWDk62u4Ne727Hg4dgOLp_HPSHgeIs7gU-BMiUhSRkoYY4o0ISziYyFEJTJn1kmkDEdAaE6SiKYRISQUOquOQTxTvofOOdW_PegKuTMncKiiKtwDQu8eZYyIhFzKMXG1RZ45yFLJnbvEztMqEkWXWcrDpO1h17-GzrbSYl6B36W6oH6Ab4yAtY_qNKnkaDm430B-Ubh90</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Yu, Panxi</creator><creator>Zhai, Haixin</creator><creator>Li, Zhijin</creator><creator>Dong, Ruijia</creator><creator>Wu, Tingting</creator><creator>Li, Yunzhu</creator><creator>Di, Zhang</creator><creator>Sun, Yixin</creator><creator>Long, Xiao</creator><creator>Yu, Nanze</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1667-7908</orcidid><orcidid>https://orcid.org/0000-0003-0136-2508</orcidid></search><sort><creationdate>202201</creationdate><title>Pivotal role of injection volume on sunken cheek prevention in masseter muscle BoNT‐A injection: A cadaver study</title><author>Yu, Panxi ; Zhai, Haixin ; Li, Zhijin ; Dong, Ruijia ; Wu, Tingting ; Li, Yunzhu ; Di, Zhang ; Sun, Yixin ; Long, Xiao ; Yu, Nanze</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3298-3294e5a260626de9f145032b5644d1254d1fd0e72dfe02d779eb604161c353bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>botulinum neurotoxin A</topic><topic>Botulinum Toxins, Type A - therapeutic use</topic><topic>Cadaver</topic><topic>cadaver study</topic><topic>Cheek</topic><topic>Humans</topic><topic>Hypertrophy - drug therapy</topic><topic>indocyanine green</topic><topic>Injections, Intramuscular</topic><topic>Masseter Muscle</topic><topic>masseter muscle hypertrophy</topic><topic>Neuromuscular Agents - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yu, Panxi</creatorcontrib><creatorcontrib>Zhai, Haixin</creatorcontrib><creatorcontrib>Li, Zhijin</creatorcontrib><creatorcontrib>Dong, Ruijia</creatorcontrib><creatorcontrib>Wu, Tingting</creatorcontrib><creatorcontrib>Li, Yunzhu</creatorcontrib><creatorcontrib>Di, Zhang</creatorcontrib><creatorcontrib>Sun, Yixin</creatorcontrib><creatorcontrib>Long, Xiao</creatorcontrib><creatorcontrib>Yu, Nanze</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cosmetic dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yu, Panxi</au><au>Zhai, Haixin</au><au>Li, Zhijin</au><au>Dong, Ruijia</au><au>Wu, Tingting</au><au>Li, Yunzhu</au><au>Di, Zhang</au><au>Sun, Yixin</au><au>Long, Xiao</au><au>Yu, Nanze</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pivotal role of injection volume on sunken cheek prevention in masseter muscle BoNT‐A injection: A cadaver study</atitle><jtitle>Journal of cosmetic dermatology</jtitle><addtitle>J Cosmet Dermatol</addtitle><date>2022-01</date><risdate>2022</risdate><volume>21</volume><issue>1</issue><spage>137</spage><epage>141</epage><pages>137-141</pages><issn>1473-2130</issn><eissn>1473-2165</eissn><abstract>Background Botulinum neurotoxin A injection is a popular noninvasive alternative for the treatment of masseter hypertrophy. This study was conducted to identify a safe injection volume to avoid sunken lateral cheek after botulinum neurotoxin A injection in the masseter muscle. Methods One milliliter or 0.5 ml of indocyanine green was randomly injected into either side of the masseter muscles of 18 fresh cadaver heads. The bilateral spreads of indocyanine green within the masseter were observed by a fluorescence imager. The masseters were then dissected, and the spreading distance was measured. Results Dye spreading showed an oval shape parallel to the long axis of the masseter muscle. The lower edges of the masseters were all stained with indocyanine green. The upward spreading exceeded the mouth corner‐tragus line in 94.44% (17/18) of the masseters on the 1‐ml side, and 11.11% (2/18) of the masseters on the 0.5‐ml side. The spreading area and upward spreading distance on the 1‐ml side (9.95 ± 0.48 cm2, 3.18 ± 0.31 cm) were significantly larger than the 0.5‐ml side (7.13 ± 0.80 cm2, 2.08 ± 0.32 cm). Conclusions The spread of indocyanine green within the masseter occurs in direct proportion to its volume. A bolus of 1 ml easily exceeded the mouth corner‐tragus line and cause sunken cheek.</abstract><cop>England</cop><pmid>34897934</pmid><doi>10.1111/jocd.14658</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-1667-7908</orcidid><orcidid>https://orcid.org/0000-0003-0136-2508</orcidid></addata></record>
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subjects botulinum neurotoxin A
Botulinum Toxins, Type A - therapeutic use
Cadaver
cadaver study
Cheek
Humans
Hypertrophy - drug therapy
indocyanine green
Injections, Intramuscular
Masseter Muscle
masseter muscle hypertrophy
Neuromuscular Agents - therapeutic use
title Pivotal role of injection volume on sunken cheek prevention in masseter muscle BoNT‐A injection: A cadaver study
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