Muscle

Origin

Insertion

Function-Innervation

Dosage-Points of Injection

Injection Depth – Technique

(Mm. epicranii)

Frontalis =

Venter frontalis = Occipitofrontalis

Dermis of the eyebrow

Middle fibers=

Process of the M.procerus

Lateral fibers= Connection with the M.corrugator supercilii & M.orbicularis oculi

Galea aponeurotica

Upward movement of the eyebrows, frontalis innervation

Antagonist of the M.orbicularis oculi, opens the palpebral fissure together with the M.levator palpebrae superioris

Innervation=

Rami temporales, N.facialis (VII)

3 to 10 points

0,5 to 2,5 U /point

Injection with a 33 Gauge, 12 mm long needle

Insertion of 10% of the needle angled to cranial direction.

Prevent the ‘’Mephisto – effect’’ by injecting laterally along the lateral part of the eyebrow.Inject 1-1,5 cm above the eye-brow, in order to avoid brow or upper eyelid ptosis through diffusion

b) Corrugator Supercilii

Pars nasales of the os frontale

Galea aponeurotica,

dermis above the middle third of

the eyebrow

Pulls eyebrows downward and toward the midline of the nose, produces the vertical rhytids of the glabella en

Innervation=

Rami temporales, N.facialis (VII)

1 point at its origin – 3 to 5 U/point

1 point at its tail- 2 to 4 U/point

Deep injection at its origin – 50% of the 12 mm needle

More superficial at its tail – insertion of 10% of the needle

(M.orbicularis oculi)

Pars palpebralis

Pars orbitalis

Pars lacrimalis

Lig.palpebrale mediale

Crista lacrimalis anterior

Crista lacrimalis posterior

Lig.palpebrale laterale

Concentric around the lateral canthus

Pars palpebralis

Lid closing reflex,

Lid closing

Directed drainage of tears

Innervation=

Rami temporales & zygomatici of the N.facialis (VII)

Inject never more than 25 U per eye

3 to 8 points

2,5 to 5 U/ per point

Use always max. 1,25 U near the lower lid and strict subcutaneous

Direct the injection always away from the eye

Insertion of 50% of the needle into the lateral lines

Insertion of 10% of the needle near the lateral end of the brow

Strict subcutaneous injections 0,5 -1 cm away from the lower lid due to ectropion danger or visual complications due to diffusion possibility

(Nose muscles)

a)Procerus

b1)Nasalis,

Pars transversa

b2)Nasalis,

Pars alaris

Os nasale

Maxilla, skin over the canine tooth

Skin over the lateral incisor

Dermis between the eyebrows

Nasal dorsum

Greater alar cartilage

Synergist of the M. Corrugator supercilii, draws down the dermis of the medial part of the eyebrows to the root of the nose,

creates the horizontal lines located at the root of the nose

Innervation=

Rami buccales, N.facialis (VII)

Compresses the nostrils

Dilates the nostrils

Innervation=

Rami buccales, N.facialis (VII)

1 to 2 points

5 to 7,5 U/point

1 to 2 points

2,5 – 5 U/point

1 point

2,5-3 U/point

Deep injections – insertion of 50% of the 12 mm long needle.

Intramuscular insertion of the needle under an angle of 45o to the skin and with a direction towards the nasal dorsum -inject inferior to the angular vein

Intramuscular injection in the middle part of the nostril

(Oral muscles)

a1)Zygomaticus major

a2)Zygomaticus minor

Anterior of zygomatic

Modiolus of the mouth

Pulls the angle of the mouth up and backwards, depresses the nasolabial fold during smiling

Moves upper lip upward

Innervation=

Rami zygomatici, N.facialis (VII)

1 to 2 points

2,5 U/point

1 point

2,5 U/point

Superficial injection. Insert 30% of the 12 mm long needle

b)M. orbicularis oris

b1)Pars marginalis

b2)Pars labialis

Mandible, Maxilla,

Perioral skin

Skin around the lips

Closing the mouth, pucker up the lips

Closing the mouth,

Pressing lips against the teeth

Innervation=

Rami buccales & Ramus marginalis mandibulae, N.facialis (VII)

4 to 6 points

1,25 U/point

Superficial injection. Estimatedly 2-3 mm above the vermilion border. Insert 10-20% of the needle