Guidelines for Botulinum Neurotoxin Injection for Facial Contouring

Kyu Ho Yi, Hyung Jin Lee, Hye Won Hur, Kyle K. Seo, Hee Jin Kim

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Summary: The hypertrophied temporalis and masseter muscles give a muscular shaped and bulky contour to the face. Botulinum neurotoxin injection methods are commonly used for facial contouring; however, adverse effects have been reported owing to a lack of delicate anatomical information. The anatomical considerations when injecting botulinum neurotoxin into the temporalis and masseter muscles were reviewed in the present study. Current knowledge on the localization of the botulinum neurotoxin injection point with more recent anatomical dissection and modified Sihler staining procedures was assessed. The authors found that, for the muscles, the injection point can be more precisely demarcated. Optimal injection sites are presented for the temporalis and masseter muscles, and the injection technique is suggested. The authors propose the optimal injection sites in relation to external anatomical landmarks for the frequently injected muscles of the face to facilitate the efficiency of botulinum neurotoxin injections. In addition, these guidelines would aid in more precise practice without the adverse effects of botulinum neurotoxin.

Original languageEnglish
Pages (from-to)562E-571E
JournalPlastic and reconstructive surgery
Issue number3
Publication statusPublished - 2022 Sept 1

Bibliographical note

Funding Information:
This work was supported by the Korea Medical Device Development Fund grant funded by the Korean government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health and Welfare, and the Ministry of Food and Drug Safety; Project Number: 1711138194, KMDF_PR_20200901_0109-01). This study was conducted in compliance with the principles set forth in the Declaration of Helsinki. Consent was received from the families of the deceased patients before beginning the dissections. The authors sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase mankind’s overall knowledge, which can then improve patient care. Therefore, these donors and their families deserve our highest gratitude. The authors thank Eun-Byul Yi from Eonbuk Elementary School for illustrations.

Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Surgery


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