Keywords
Botulinum Toxin A
Dermal Filler Products
Treatment Outcome
How to Cite
Abstract
Objectives: To evaluate the prevalence of anatomical variations of noble facial structures and their impact on the results of orofacial harmonization. Methodology: This is a literature review that was carried out between February and March 2025. The question that guided the search was “What are the implications of facial anatomical variations on the results of orofacial harmonization?”. From this, a search was carried out in the PubMed (U.S. National Library of Medicine) and BVS (Virtual Health Library) databases, with a time lapse of 5 years. The search strategy was formulated by combining the descriptors indexed in DeCS/MeSH “Anatomical Variation”, “Botulinum Toxin A”, “Dermal Filler Products” and “Treatment Result”, combined with the Boolean operator “AND”. The selection criteria were: studies published in the last 5 years, related to the guiding question, with full text available in Portuguese, English and Spanish, systematic literature reviews, meta-analyses and randomized clinical trials. The initial search resulted in the identification of 34 articles. Of these, 5 articles were included in the research. Conclusion: Anatomical variations in facial muscles and blood vessels directly impact the results of orofacial harmonization. Differences in muscle connections can alter the distribution of botulinum toxin, influencing facial expressiveness and symmetry. Variations in the path and branching of vessels, especially the facial artery, affect the safety of fillers, requiring precise planning to avoid complications.
References
DARWIN, C. The expression of the emotions in man and animals. anboco, 2016.
HUR, M. et al. Anatomical connections among the depressor supercilii, levator labii superioris alaeque nasi, and inferior fibers of orbicularis oculi: implications for variation in human facial expressions. PLoS One, v. 17, n. 3, p. e0264148, 2022.
HUR, M. Anatomical relationships of the procerus with the nasal ala and the nasal muscles: transverse part of the nasalis and levator labii superioris alaeque nasi. Surgical and Radiologic Anatomy, v. 39, p. 865-869, 2017.
KUCUKGUVEN, A. et al. A novel injection technique to the lateral pterygoid muscle for temporomandibular disorders: a cadaveric study. Plastic and reconstructive surgery, v. 148, n. 5, p. 785e-790e, 2021.
LEE, S. et al. A novel description of the supporting system of the orbicularis oculi muscle in the infraorbital area: Tear trough muscle fiber. Surgical and Radiologic Anatomy, v. 46, n. 1, p. 3-9, 2024.
LOUKAS, M. et al. A detailed observation of variations of the facial artery, with emphasis on the superior labial artery. Surgical and Radiologic Anatomy, v. 28, p. 316-324, 2006.
PADUR, A. A.; KUMAR, N. Unusual branching pattern and termination of facial artery and its clinical implications for facial operations. Jornal Vascular Brasileiro, v. 18, p. e20190021, 2019.
PINAR, Y. et al. Anatomocosmetic implication rules of the corrugator supercilii muscle for youthful eye appearance. Surgical and Radiologic Anatomy, v. 38, p. 1045-1051, 2016.
SIWETZ, M. et al. A rare case of facial artery branching—a review of the literature and a case report with clinical implications. Medicina, v. 57, n. 11, p. 1172, 2021.
SUN, Y. et al. The dorsal nasal complex in Asians: anatomical variations and injection guide for botulinum toxin type A. Aesthetic Surgery Journal, v. 43, n. 7, p. 760-770, 2023.
YI, K.; WAN, J. Anatomical considerations of medial eye wrinkles: Guidelines for botulinum neurotoxin injections. Journal of Cosmetic Dermatology, v. 23, n. 11, p. 3503-3507, 2024.
WALLER, B. M. et al. Intramuscular electrical stimulation of facial muscles in humans and chimpanzees: Duchenne revisited and extended. Emotion, v. 6, n. 3, p. 367, 2006.
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Copyright (c) 2025 Maria Eduarda Darigo Vasconcelos, Ana Carolina Feliciano Gonçalves Lima, Anne Karolyne da Silva Lopes, David Albert Dodoo, Ester Alves Silva Barbosa, Graziella Valda Oliveira Sousa Bôa Morte, Kethilly Mirely da Silva, Leila Pinheiro, Letícia Maria de Arruda Barbosa Lima, Maria Amylle Bezerra dos Santos Silva, Maria Eduarda da Silva Souza, Naama Júlia Mota Ferreira, Otavio Rocha Gonçalves Fonseca, Safira Gabriela Silva de Santana, Samara Pillar Bezerra de Souza Ferraz