Facial Ultrasound Anatomy for Non-invasive Cosmetic and Plastic Surgery Procedures

  • Ximena WortsmanEmail author
  • Camila Ferreira-Wortsman
  • Natacha Quezada


Ultrasound unveils in vivo the anatomical characteristics and location of relevant structures of the face. This non-invasive imaging modality can support the performance of non-invasive cosmetic and plastic surgery procedures and the early detection of complications. This chapter reviews the sonographic features of the main anatomical structures of the face performing a clinical-ultrasonographic correlation.


Ultrasound face Ultrasound cosmetics Ultrasound aesthetic Ultrasound plastic surgery Ultrasound facial anatomy Ultrasound anatomy Dermatologic ultrasound Skin ultrasound Ultrasound dermatology 


  1. 1.
    Dayan SH. Complications from toxins and fillers in the dermatology clinic: recognition, prevention, and treatment. Facial Plast Surg Clin North Am. 2013;21:663–73.CrossRefPubMedGoogle Scholar
  2. 2.
    Prendergast PM. Anatomy of the face and neck. In: Shiffman MA, Di Giuseppe A, editors. Cosmetic surgery: art and techniques. Berlin: Springer; 2013. p. 29–45.CrossRefGoogle Scholar
  3. 3.
    Kim HJ, Seo KK, Lee HK, Kim J. Clinical anatomy of the face for filler and botulinum toxin injection. Singapore: Springer; 2015.Google Scholar
  4. 4.
    Wortsman X, Wortsman J. Sonographic outcomes of cosmetic procedures. Am J Roentgenol. 2011;197:W910–8.CrossRefGoogle Scholar
  5. 5.
    Costin BR, Plesec TP, Sakolsatayadorn N, Rubinstein TJ, McBride JM, Perry JD. Anatomy and histology of the frontalis muscle. Ophthal Plast Reconstr Surg. 2015;31:66–72.CrossRefPubMedGoogle Scholar
  6. 6.
    Hwang K, Lee JH, Lim HJ. Anatomy of the corrugator muscle. J Craniofac Surg. 2017;28:524–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Janis JE, Ghavami A, Lemmon JA, Leedy JE, Guyuron B. Anatomy of the corrugator supercilii muscle: part I. Corrugator topography. Plast Reconstr Surg. 2007;120:1647–53.CrossRefPubMedGoogle Scholar
  8. 8.
    Sand JP, Zhu BZ, Desai SC. Surgical anatomy of the eyelids. Facial Plast Surg Clin North Am. 2016;24:89–95.CrossRefPubMedGoogle Scholar
  9. 9.
    Hwang K, Kim HJ, Kim H, Kim DJ, Hwang SW. Origin of the lower orbicularis oculi muscle in relation to the nasojugal groove. J Craniofac Surg. 2015;26:1389–93.CrossRefPubMedGoogle Scholar
  10. 10.
    Pessa JE, Zadoo VP, Garza PA, Adrian EK Jr, Dewitt AI, Garza JR. Double or bifid zygomaticus major muscle: anatomy, incidence, and clinical correlation. Clin Anat. 1998;11:310–3.CrossRefPubMedGoogle Scholar
  11. 11.
    Bo C, Ningbei Y. Reconstruction of upper lip muscle system by anatomy, magnetic resonance imaging, and serial histological sections. J Craniofac Surg. 2014;25:48–54.CrossRefPubMedGoogle Scholar
  12. 12.
    Hur MS, Hu KS, Park JT, Youn KH, Kim HJ. New anatomical insight of the levator labii superioris alaeque nasi and the transverse part of the nasalis. Surg Radiol Anat. 2010;32:753–6.CrossRefPubMedGoogle Scholar
  13. 13.
    Abramo AC, Do Amaral TP, Lessio BP, De Lima GA. Anatomy of forehead, glabellar, nasal and orbital muscles, and their correlation with distinctive patterns of skin lines on the upper third of the face: reviewing concepts. Aesthet Plast Surg. 2016;40:962–71.CrossRefGoogle Scholar
  14. 14.
    Koerte IK, Schroeder AS, Fietzek UM, Borggraefe I, Kerscher M, Berweck S, et al. Muscle atrophy beyond the clinical effect after a single dose of Onabotulinum toxin A injected in the procerus muscle: a study with magnetic resonance imaging. Dermatol Surg. 2013;39(5):761.CrossRefPubMedGoogle Scholar
  15. 15.
    Bae JH, Choi DY, Lee JG, Seo KK, Tansatit T, Kim HJ. The risorius muscle: anatomic considerations with reference to botulinum neurotoxin injection for masseteric hypertrophy. Dermatol Surg. 2014;40:1334–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Choi YJ, Kim JS, Gil YC, Phetudom T, Kim HJ, Tansatit T, Hu KS. Anatomical considerations regarding the location and boundary of the depressor anguli oris muscle with reference to botulinum toxin injection. Plast Reconstr Surg. 2014;134:917–21.CrossRefPubMedGoogle Scholar
  17. 17.
    Hur MS, Kim HJ, Choi BY, Hu KS, Kim HJ, Lee KS. Morphology of the mentalis muscle and its relationship with the orbicularis oris and incisivus labii inferioris muscles. J Craniofac Surg. 2013;24:602–4.CrossRefPubMedGoogle Scholar
  18. 18.
    Kaya B, Apaydin N, Loukas M, Tubbs RS. The topographic anatomy of the masseteric nerve: A cadaveric study with an emphasis on the effective zone of botulinum toxin A injections in masseter. J Plast Reconstr Aesthet Surg. 2014;67:1663–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Lohn JW, Penn JW, Norton J, Butler PE. The course and variation of the facial artery and vein: implications for facial transplantation and facial surgery. Ann Plast Surg. 2011;67:184–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Cotofana S, Pretterklieber B, Lucius R, Frank K, Haas M, Schenck TL, et al. Distribution pattern of the superior and inferior labial arteries: impact for safe upper and lower lip augmentation procedures. Plast Reconstr Surg. 2017;139:1075–82.CrossRefPubMedGoogle Scholar
  21. 21.
    Tansatit T, Apinuntrum P, Phetudom T. Cadaveric assessment of lip injections: locating the serious threats. Aesthet Plast Surg. 2017;41:430–40.CrossRefGoogle Scholar
  22. 22.
    Gocmen-Mas N, Edizer M, Keles N, Aksu F, Magden O, Lafci S, et al. Morphometrical aspect on angular branch of facial artery. J Craniofac Surg. 2015;26:933–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Lee WW, Erickson BP, Ko MJ, Liao SD, Neff A. Advanced single-stage eyelid reconstruction: anatomy and techniques. Dermatol Surg. 2014;40(Suppl 9):S103–12.CrossRefPubMedGoogle Scholar
  24. 24.
    Karimnejad K, Walen S. Complications in eyelid surgery. Facial Plast Surg Clin North Am. 2016;24:193–203.CrossRefPubMedGoogle Scholar
  25. 25.
    Alfen NV, Gilhuis HJ, Keijzers JP, Pillen S, Van Dijk JP. Quantitative facial muscle ultrasound: feasibility and reproducibility. Muscle Nerve. 2013;48:375–80.CrossRefPubMedGoogle Scholar
  26. 26.
    Volk GF, Wystub N, Pohlmann M, Finkensieper M, Chalmers HJ, Guntinas-Lichius O. Quantitative ultrasonography of facial muscles. Muscle Nerve. 2013;47:878–83.CrossRefPubMedGoogle Scholar
  27. 27.
    Volk GF, Pohlmann M, Sauer M, Finkensieper M, Guntinas-Lichius O. Quantitative ultrasonography of facial muscles in patients with chronic facial palsy. Muscle Nerve. 2014;50:358–65.CrossRefPubMedGoogle Scholar
  28. 28.
    Volk GF, Pohlmann M, Finkensieper M, Chalmers HJ, Guntinas-Lichius O. 3D-Ultrasonography for evaluation of facial muscles in patients with chronic facial palsy or defective healing: a pilot study. BMC Ear Nose Throat Disord. 2014;14:4.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Olszewski R, Liu Y, Duprez T, Xu TM, Reychler H. Three-dimensional appearance of the lips muscles with three-dimensional isotropic MRI: in vivo study. Int J Comput Assist Radiol Surg. 2009;4:349–52.CrossRefPubMedGoogle Scholar
  30. 30.
    Tucunduva MJ, Tucunduva-Neto R, Saieg M, Costa AL, de Freitas C. Vascular mapping of the face: B-mode and doppler ultrasonography study. Med Oral Patol Oral Cir Bucal. 2016;21:e135–41.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Quezada-Gaon N, Wortsman X, Peñaloza O, Carrasco JE. Comparison of clinical marking and ultrasound-guided injection of Botulinum type A toxin into the masseter muscles for treating bruxism and its cosmetic effects. J Cosmet Dermatol. 2016;15:238–44.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Ximena Wortsman
    • 1
    • 2
    • 3
    Email author
  • Camila Ferreira-Wortsman
    • 4
  • Natacha Quezada
    • 5
  1. 1.IDIEPInstitute for Diagnostic Imaging and Research of the Skin and Soft TissuesSantiagoChile
  2. 2.Department of DermatologyUniversidad de ChileSantiagoChile
  3. 3.Department of DermatologyPontificia Universidad Católica de ChileSantiagoChile
  4. 4.Faculty of Medicine, Universidad Finis TerraeSantiagoChile
  5. 5.Department of DermatologyPontificia Universidad Catolica de Chile, Hospital Clinico Universidad CatólicaSantiagoChile

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