NESPS - Microcomputed Tomography (Micro-CT) Mapping of Corrugator Supercilii and Procerus Anatomy: Implications for Procedures Involving the Glabellar Musculature

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Microcomputed Tomography (Micro-CT) Mapping of Corrugator Supercilii and Procerus Anatomy: Implications for Procedures Involving the Glabellar Musculature
Hunter M. Rogoff¹, Maxim Narduzzi^*2, Daniel Maskovsky², Sean Devitt¹
¹Department of Plastic and Reconstructive Surgery, Geisinger Medical Center, Danville, PA; ²New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY

Background
A detailed understanding of the glabella musculature is essential for performing safe and effective chemodenervation, forehead rejuvenation surgery, and migraine trigger-site nerve decompression. Most existing studies focus on defining surface anatomy rather than three-dimensional (3D) parameters. In this study, the authors employed advanced imaging technology to analyze the multi-dimensional characteristics of the corrugator supercilii and procerus muscles, including their relationships to key facial landmarks, depth beneath the skin across regions, and variations in muscle thickness.

Methods
Ten adult cadavers - 5 male, 5 female - were analyzed using high-resolution micro-computed tomography (micro-CT) to obtain precise 3D measurements of the glabella musculature. An advanced specimen staining protocol was utilized to improve visualization of the muscles. Corrugator and procerus dimensions, regional thickness, and depth from skin were measured. Sex-based comparisons were performed.

Results
Corrugator musculature did not reveal significant left-right asymmetries (all p > 0.05). Corrugator depth from skin decreased from 3.82 mm at the medial canthus (MC), to 3.41 mm at the midpupil (MP), to 2.69 mm at the lateral limbus (LL) (-1.13 mm, p = 0.002). Corrugator thickness showed a parallel gradient, decreasing from 1.52 mm at the MC, to 1.28 mm at the MP, to 0.95 mm at the LC (-0.57, p < 0.001). Procerus thickness inferiorly (0.87 mm) was thinner than both centrally (1.38 mm, p = 0.020) and superiorly (1.34, p = 0.006). Sex-based comparisons revealed no significant differences (all p > 0.05).

Conclusions
This study used high-resolution micro-CT technology to map the 3D structure and topography of the corrugator supercilii and procerus muscles without tissue distortion inherent in gross dissection, building upon the established literature. The corrugator becomes progressively thinner and more superficial laterally, while the procerus demonstrates relative inferior attenuation. Knowledge of these relationships can help to improve injection and surgical precision.

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