Relationship Between Vertical Glabellar Lines and the Supratrochlear and Supraorbital Arteries.

BACKGROUND Glabellar soft tissue filler injections have been shown to be associated with a high risk for causing injection related visual compromise. OBJECTIVES To identify the course of the superficial branch of the supratrochlear and of the deep branch of the supraorbital artery in relation to the ipsilateral vertical glabellar line and to test whether the artery is located in its depth. METHODS 41 healthy volunteers with a mean age of 26.17 ± 9.6 years and a mean BMI of 23.09 ± 2.3 kg/m2 were analyzed. Ultrasound imaging was applied to measure the diameters, distance between skin surface, distance between the midline and distance between vertical glabella lines and the cutaneous projection of supratrochlear/supraorbital arteries at rest and upon frowning. RESULTS The distance between the superficial branch of the supratrochlear artery and the ipsilateral vertical glabellar line was 10.59 ± 4.0 mm in males and 8.21 ± 4.0 mm in females whereas it was 22.38 ± 5.5 mm for the supraorbital artery in males and 20.73 ± 5.6 mm in females. Upon frowning, a medial shift in supratrochlear arterial position of 1.63 mm in males and 1.84 mm in females and of 3.9 mm in supraorbital arterial position for both genders was observed. The depth of the supratrochlear artery was 3.34 ± 0.6 mm at rest whereas the depth of the supraorbital artery was 3.54 ± 0.8 mm. CONCLUSIONS The hypothesis that injecting soft tissue fillers next to vertical glabellar lines is safe because the artery courses deep to the crease should be rejected. Additionally, the glabella and the supraorbital region should be considered as an area of mobile soft tissues rather than static.