Hyun Jin Park1, Ji-Hyun Lee1, Kyu-Lim Lee1, You-Jin Choi1, Kyung-Seok Hu1, Hee-Jin Kim1,2. 1. Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea. 2. Department of Materials Science & Engineering, College of Engineering, Yonsei University Seoul, Republic of Korea.
Abstract
BACKGROUND: Filler injection into the glabella is well known to be one of the most dangerous procedures due to the high risk of embolism and intravascular injection. Despite the conventional insertion guidelines for the cannula in the middle of the forehead for injections into the glabella or radix, vascular structures can be observed during anatomical dissection procedures. OBJECTIVES: The aim of this study was to characterize the blood vessels around the forehead midline in order to provide crucial anatomical information for ensuring the safety of noninvasive procedures involving the forehead and glabella. METHODS: Ultrasonography image scanning was performed at the following four points on the forehead midline: trichion (P1), metopion (P2), half point between metopion and glabella (P3), and glabella (P4). The courses and locations of vessels were identified and classified according to their proximity to the forehead midline. RESULTS: Vessels coursing within 0.75 cm either side of the forehead midline were found in 34-50% of individuals. Arteries running near the forehead midline tended to be dominant on the right side of the forehead except in the P4 area. About half of the individuals had vessels in the P4 area, of which 96.7% were veins. CONCLUSIONS: The present results indicate that there are superficial vessels running close to the midline of the forehead. This anatomical information can explain the higher incidence of vascular complications during conventional aesthetic procedures. To ensure safety, the cannula entry point or needle puncture point for glabella augmentation should be reconsidered.
BACKGROUND: Filler injection into the glabella is well known to be one of the most dangerous procedures due to the high risk of embolism and intravascular injection. Despite the conventional insertion guidelines for the cannula in the middle of the forehead for injections into the glabella or radix, vascular structures can be observed during anatomical dissection procedures. OBJECTIVES: The aim of this study was to characterize the blood vessels around the forehead midline in order to provide crucial anatomical information for ensuring the safety of noninvasive procedures involving the forehead and glabella. METHODS: Ultrasonography image scanning was performed at the following four points on the forehead midline: trichion (P1), metopion (P2), half point between metopion and glabella (P3), and glabella (P4). The courses and locations of vessels were identified and classified according to their proximity to the forehead midline. RESULTS: Vessels coursing within 0.75 cm either side of the forehead midline were found in 34-50% of individuals. Arteries running near the forehead midline tended to be dominant on the right side of the forehead except in the P4 area. About half of the individuals had vessels in the P4 area, of which 96.7% were veins. CONCLUSIONS: The present results indicate that there are superficial vessels running close to the midline of the forehead. This anatomical information can explain the higher incidence of vascular complications during conventional aesthetic procedures. To ensure safety, the cannula entry point or needle puncture point for glabella augmentation should be reconsidered.