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Body Painting Helps Teach Plastic Surgeons the Art of Botox Injection

An exquisitely detailed body painting project can help plastic surgeons understand how underlying muscles contribute to facial lines and wrinkles, along with their effective treatment using botulinum toxin injection, according to a paper in Plastic and Reconstructive Surgery—Global Open®, the official open-access medical journal of the American Society of Plastic Surgeons (ASPS).

The illustrated article by Ricardo Frota Boggio, MD, PhD, of Universidade de São Paulo, Brazil, presents and describes this approach to studying the anatomy and function of the facial muscles.

Dr. Boggio said, "This innovative method, in a playful and highly didactic manner, presents great potential as a teaching tool in the application of botulinum toxin A."

Art Project Helps Show Facial Muscles Cause Wrinkles

Botulinum toxin A is an effective treatment for facial lines and wrinkles; it works by temporarily inactivating the contributing underlying muscles. In Dr. Boggio's view, lack of understanding of the applied anatomy of the facial muscles and how they generate hyperkinetic wrinkles is a major shortcoming of current approaches to teaching botulin toxin injection.

The artful anatomy lesson employed a 37-year-old female model with typical hyperkinetic facial wrinkles, such as forehead lines, crow's feet around the eyes and lines around the mouth. Wrinkles in these and other areas are called by repetitive action of the facial muscles.

A professional artist painted the underlying muscles of the face and neck on one side of the model's face. The model was then photographed and videotaped as she made various facial expressions to reproduce facial lines and wrinkles.

This provided a unique opportunity to study and appreciate the how the facial muscles, individually and in interaction with each other, work to produce expressive movement of the face and to generate facial wrinkles. Looking at the opposite, unpainted side helped trainees see the corresponding appearance on clinical examination.

Botulinum toxin A injection is by far the most common cosmetic procedure, with more than seven million procedures performed in the United States in 2016, according to ASPS statistics. It is remarkably safe and effective in reducing facial wrinkles. Especially with the rising popularity of this procedure, better methods of teaching botulinum toxin injection technique are needed.

In addition to color photographs, the online article includes brief videos of the body painting project, showing the relationship between facial movements and facial wrinkles and demonstrating proper botulinum toxin injection technique in each treated area.

Dr. Boggio said, "By correlating facial muscle function with the presence of hyperkinetic wrinkles, this novel teaching tool provides trainees with information of great practical importance for the preparation of highly effective treatments and low complication rates."

Plastic and Reconstructive Surgery—Global Open® is published by Wolters Kluwer.

About PRS Global Open

Plastic and Reconstructive Surgery—Global Open (PRS Global Open) is an open access, rigorously peer-reviewed, international journal focusing on global plastic and reconstructive surgery. PRS Global Open educates and supports plastic surgeons globally to provide the highest quality patient care and maintain professional and ethical standards through education, research, and advocacy.

About ASPS

The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. 

About Wolters Kluwer

Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world.

Wolters Kluwer reported 2015 annual revenues of €4.2 billion. The group serves customers in over 180 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).

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