Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng District, Beijing, 100730, China.
The Seventh Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Aesthetic Plast Surg. 2022 Feb;46(1):406-418. doi: 10.1007/s00266-021-02493-z. Epub 2021 Aug 2.
Botulinum toxin (BoNT) injection is the most commonly performed procedure in cosmetic surgery. However, blind injection is unable to take individual anatomical variations into consideration, which is the main contributing factor to complications. Ultrasound (US) imaging was introduced to reduce complications and improve effects. This article will review uses of US in aesthetic BoNT injection.
A systematic electronic search was performed using the PubMed, MEDLINE, Web of science. Search terms were set to focus on aesthetic BoNT injection. Two independent reviewers subsequently reviewed the resultant articles based on strict inclusion and exclusion criteria. Selected manuscripts were analysed and grouped by procedure categories. Clinical cases were all performed by one plastic surgeon in our department.
The search finally retained 24 articles. Five procedural categories were identified, including masseter (n = 16), frontalis (n = 2), glabella complex (n = 2), trapezius (n=1), and gastrocnemius (n = 3). US imaging is practical and instructive for pre-operative assessments as in needle-type selection, injection point localization and depth setting, as well as post-operative follow-ups regarding injection feedback (for instance, the extent of muscle volume decreases). What's more, ultrasound-guided injection makes needle trajectory visualized so as for the needle to reach the target muscle in avoidance of potential damage to neurovascular bundle, gland or adjacent muscle.
Muscles, such as masseter, frontalis, glabella complex, trapezius and gastrocnemius, and their adjacent structures can be well visualized using US, and as such, US can be a useful tool for a variety of pre-operative, intra-operative and post-operative procedures.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
肉毒毒素（BoNT）注射是美容外科最常进行的操作。然而，盲目注射无法考虑个体解剖学的变化，这是导致并发症的主要因素。超声（US）成像的引入降低了并发症的发生率并提高了疗效。本文将综述超声在美容 BoNT 注射中的应用。
系统地检索了 PubMed、MEDLINE 和 Web of Science 数据库，检索词集中于美容 BoNT 注射。两位独立的审查员根据严格的纳入和排除标准对得到的文章进行了回顾。选择的文献按照操作类别进行了分析和分组。所有的临床病例均由我科的一位整形医生完成。
最终检索到 24 篇文章。确定了 5 个操作类别，包括咬肌（n = 16）、额肌（n = 2）、眉间复合体（n = 2）、斜方肌（n = 1）和腓肠肌（n = 3）。超声成像在术前评估中具有实用性和指导意义，如针型选择、注射点定位和深度设置，以及术后随访中评估注射反馈（例如，肌肉体积减少的程度）。此外，超声引导下的注射可以使针的轨迹可视化，使针能够到达目标肌肉，从而避免对神经血管束、腺体或邻近肌肉的潜在损伤。
超声可以很好地显示咬肌、额肌、眉间复合体、斜方肌和腓肠肌及其邻近结构，因此超声可以成为各种术前、术中、术后操作的有用工具。
证据等级 IV：本杂志要求作者为每篇文章分配一个证据等级。有关这些循证医学评级的完整描述，请参考目录或在线作者指南 www.springer.com/00266 。
