Anatomical considerations for Facial and

Periocular Botulinum Toxin

Ajay Krishnamurthy
Muscles of Facial Expression
• Face is the index of mind
• Muscles which contributes to expressions also cause unavoidable
wrinkles to appear
• Our interest being in muscles which result in wrinkles
Facial muscles
Distributed in different regions of the face
1. Forehead Region (Skin depth 1.08mm)
2. Temporal Region (1.06mm)
3. Orbital Region (0.38-0.83mm)
4. Nose Region (0.77- 1.25mm)
5. Perioral Muscles (0.86mm)
1. Forehead Region

• Occipitofrontalis – Frontal belly and

occipital belly Frontalis

• Orgin Galea aponeurosis  Inserts to

orbicularis oculi and the frontal skin
above the eyebrow
• Its muscle fibers are vertically oriented
• Produces transverse wrinkles on the
forehead
2. Temporal Region
Temporalis
• Fan-shaped temporalis is divided into two
layers: superficial and deep
• Orginates from broad temporal fossa and
inserts inferiorly to tip and medial surface
of coronoid process of mandible
• Anterior temporalis fibers proceed almost
vertically, the fibers of the posterior
temporalis run almost horizontally
• Raises the mandible for mouth closing
3. Orbital Region
• Orbicularis oculi – Elliptical muscle Orbicularis oculi
• Composed of orbital part and
palpebral part
• Mediate eye closure
• Tightens around the eye and pulls
the skin forward, causing crow's feet
Various direct and indirect muscular connections exist between
the orbicularis oculi and the surrounding musculature

• Corrugator supercilii
• Procerus
• Frontalis
• Zygomaticus major and zygomaticus minor
Corrugator supercilii Oblique belly

• Consists of two distinct bellies—the

transverse and oblique belly Transverse belly

• Originates from the periosteum of the

frontal bone and then merges with the
frontalis
• Transverse belly is deeper and more
horizontal
• This muscle makes narrow, vertical wrinkles
on the glabellar region
Depressor supercilii
Depressor supercilii

• Fan-shaped or triangular-shaped muscle

• Origin- medial orbital rim, near
the lacrimal bone, and inserts on the
medial aspect of the bony orbit
• Proceeds through the glabella being
mixed with the corrugator supercilii and
intermingles with medial fibers of the
orbicularis oculi
• Pulls the medial brow downward
causing horizontal lines
4. Nose Region
Procerus
Procerus
• Origin – Nasal bone and inserts to the
skin of the radix
• Makes a horizontal line on the radix
below the glabella by pulling the
medial side of the eyebrow down
• Results in Glabellar Transverse Lines
Nasalis Transverse part
Origin: Alveolar eminence of lateral incisor &
canine of upper jaw at the base of alveolar
Alar part
process
• 2 parts:
• Transverse part: Musculus compressor naris
• Alar part: Musculus dilator naris
• The transverse part compresses and
decreases the size of the naris, while the alar
part serves to enlarge the size of the naris
Depressor septi nasi
• Located on the deep part of the lip
• Origin from the incisive fossa (between
the central and lateral incisors) and
inserts into the moving part of the nasal
septum Depressor septi
nasi
• It pulls the nose tip inferiorly to enlarge
the size of the naris
5. Perioral muscles
Intrinsic Muscles of the Lip and
Cheek Orbicularis Oris
• Orbicularis Oris –works to close
the mouth and pucker Part of
• Buccinator Buccinator
 Zygomaticus major

Dilators of the Lips

Risorius Levator Anguli
• Zygomaticus Major- elevates the Oris

corner of mouth
• Levator Anguli Oris - elevates the Depressor Anguli
Oris
corner of mouth
• Depressor Anguli Oris - Pulls the corner
of the mouth downward and inward
• Risorius Muscle – Pulls the corner of
mouth while smiling
Major upper lip elevators Levator labii sup
• Levator labii superioris alaeque nasi alaque nasi

• Levator labii superioris Levator labii

superioris
• Zygomaticus minor
• Attached to the surface of the Zygomaticus
minor
orbicularis oris
• Involved to form the nasolabial fold
Mentalis
• Contracting Muscle of the Chin Mentalis

• Elevates the chin and the lower lip

and provides major vertical support
for the lower lip
• Produces a wrinkle in the skin of the
mentum
 Platysma
Platysma Muscle
• Covers lateral and anterior region of the
neck
• Tenses the skin producing vertical skin
ridges
• Facilitates venous flow in the neck by
keeping skin and fascia fairly taut
between mandible and clavicle
Thank you