Botulinum toxin A injection to reduce glabellar lines has become one of the most popular
procedures in facial rejuvenation. 5-site injection is generally accepted: into the procerus muscle at
the midline and each corrugator muscle at its inferomedial and superolateral aspects. The
superolateral injection site is above the pupil and approximately 1cm above the bony orbital rim.
According to our observation, corrugator muscles are not either symmetric or tightly related to the
surface anatomical landmarks such as pupils and bony orbital rims. Therefore when glabellar lines
were treated by surface anatomical landmarks, in the case of asymmetrical corrugator, it was not
precisely targeted to obtain sufficient paralytic effects. Herein, we suggest functional anatomy-based
Botulinum toxic A injection to correct glabellar frown lines and its theoretical backgrounds. Between
1999 and 2007, 329 patients were enrolled in the study. 86 patients between 1999 and February of
2001 were injected by the traditional injection method. Later 243 patients were treated by the
functional anatomy-based injection. By the new method, injection points were determined by
observing glabellar furrows and skin fine wrinkles after repetition of muscle contraction. By this
method, we could enhance the cosmetic effects and heighten patients’ satisfaction.
(J Korean Soc Aesthetic Plast Surg 17: 35, 2011)