Changes in the activity of the facial muscles after the introduction of fillers: the effect of myomodulation

Change in muscle activity after the introduction of dermal fillers is called myomodulation. To date, it has not yet been possible to fully explain the causes of this phenomenon. In connection with the recent discovery of structures similar to Ruffini bodies in the zygomatic muscles, it is assumed that a filler injected into the space near the muscle can stimulate its mechanoreceptors. In response, the autonomic nervous system changes the behavior of not only the target, but also all the raising and lowering muscles of the face.

In this article estet-portal.com Dr. the reasons for its occurrence during the introduction of fillers.

• How do dermal fillers affect facial muscles
• Why is there a myomodulation effect after the introduction of fillers
• Hypothesis on the effect of dermal fillers on mechanoreceptors 

How do dermal fillers affect facial muscles 

When correcting the face with dermal fillers, the effect of myomodulation is often observed. As a result of injection of the filler under any levator muscle in the middle or lower third of the face, the contractility of not only this muscle, but also of all levators increases; at the same time, the activity of their antagonists – lowering muscles. 
Thus, the introduction of a filler under the large zygomatic muscle stimulates not only its activity, but also its activity: 

• small zygomatic muscle;

• muscle that lifts the upper lip;

• chin lifting muscle. 

At the same time, activity is suppressed:

• depressor part of the orbicular muscle of the eye; 

• muscle that lowers the corner of the mouth; 

• muscles that lower the lower lip. 

When the drug is injected under one of the depressor muscles, a similar effect is observed – the activity of all the lowering muscles decreases, and the lifting ones – increases. 

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Conversely, if the filler is injected over the muscle, its contractility decreases.

With the introduction of the drug under one of the depressor muscles, a similar effect is observed – the activity of all the lowering muscles decreases, and the lifting ones – increases. 

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Conversely, if the filler is injected over the muscle, its contractility decreases.

With the introduction of the drug under one of the depressor muscles, a similar effect is observed – the activity of all the lowering muscles decreases, and the lifting ones – increases. 

More interesting articles in Telegram!

Conversely, if the filler is injected over the muscle, its contractility decreases.

As a result of injection of the filler under any levator muscle in the middle or lower third of the face, the contractility of not only this muscle, but also of all levators increases; at the same time, the activity of their antagonists – descending muscles.

A filler injected under a stretched muscle changes the ratio of its length and tension and, in accordance with the Frank-Starling law, contributes to a more effective contraction. The filler injected over the muscle, according to De Mayo, exerts mechanical pressure, thereby reducing its contractile activity.

Fig. 1 and 2: (A) before and (B) after the injection of dermal fillers under the levator zygomaticus and mentalis major and depressor anterolateralis muscle This explanation, according to Kane, on one On the other hand, it is logical: the levator muscles of the middle third of the face function more efficiently due to the support and elevated position after deep injection of the filler. But, on the other hand, this does not explain the behavior of the frontal levator muscle and depressor muscles. Also, a superficially injected filler exerts pressure on the muscle in all three dimensions, not just downward.

When the drug is injected under one of the depressor muscles, a similar effect is observed – the activity of all the lowering muscles decreases, and the lifting ones – rising.

According to Kane, a more reasonable explanation is that the superficially injected filler reduces the deformability of the dermis, thus indirectly reducing contractility of the underlying muscle. Moreover, he notes that there is no evidence to support the theory of muscle length gain with age, and that levator muscles weaken more than depressors. It is more likely that both levators and depressors shorten and weaken with aging, similar to bone and soft tissues. maximum effect: facelift with fillers according to The 



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protocol Hypothesis about the effect of dermal fillers on mechanoreceptors  According to the mechanoreceptor-acting hypothesis of dermal fillers, the mechanical deformation caused by the drug stimulates slowly adapting mechanoreceptors in the muscle itself. MA receptors, in turn, through autonomic and somatosensory pathways send a signal to the brain about the need to reduce sympathetic excitation associated with the activity of the levator muscle. Since the contraction of the frontal muscle – sympathetic activity, it is suppressed, unlike other levator muscles. 

The hypothesis also explains the decrease in emotional arousal caused by the decrease in sympathetic activity, as well as the more relaxed facial expressions of patients after filler injections. 

As far as superficial filler injection is concerned, the mechanism is most likely explained by the theory of Kane – muscle activity decreases due to a decrease in the ability of the dermis to deform.  

In a study by Harris et al. it was found that as a result of 15 minutes of stimulation of slowly adapting receptors in the skin of the face (via small silicone protrusions on the face mask), the severity of the brow lines, which are the result of the activity of the depressor muscle, decreased by 64%. Participants also noted an improvement in mood.

The discovery of structures similar to Ruffini's bodies and acting as mechanoreceptors in the mimic muscles of the face forms the basis of the hypothesis of effect of fillers on mechanoreceptors.

The contractility of the frontal muscle depends more on the reaction of the sympathetic nervous system, and therefore, with a deep introduction of the filler under the muscle, its contractility decreases.

So, a filler injected deep near the attachment site of the zygomaticus major muscle acts not only as a lifting block, but also as an inhibitor of the sympathetic nervous system. The filler not only stimulates the activity of the muscle itself, resulting in a raised corner of the mouth, but also increases the activity of the levators (with the exception of the frontalis muscle) and reduces the degree of emotional arousal.

As a result, there is a cumulative levator an effect that extends to the lateral part of the eyebrow; the shape of the face improves, its features become more pronounced, and the – relaxed (Fig. 1 & ndash; 3).
A similar effect is observed when the filler is deeply injected under one of the depressor muscles (for example, the muscle that lowers the corner of the mouth). As noted above, the contractility of the frontalis muscle is more related to the reaction of the sympathetic nervous system, and therefore, when the filler is deeply inserted under the muscle, its contractility decreases. Fillers injected superficially in relation to one of these muscles, simply inhibit the activity of that muscle, thus having a more localized effect. 

Adapted from Prime magazine.


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