{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:14:44Z","timestamp":1787015684288,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T00:00:00Z","timestamp":1715817600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent research introduced the concept of the \u201cline of convergence\u201d as a guide for injectors to enhance precision and avoid complications when treating the frontalis muscle with toxins. However, currently, no pre\u2010injection ultrasound scanning is employed to increase precision and reduce adverse events when searching for the line of convergence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the feasibility and practicality of implementing pre\u2010injection ultrasound scanning into aesthetic neuromodulator treatments of the forehead.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The sample of this study consisted of\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200955 volunteers (42 females and 13 males), with a mean age of 42.24 (10.3)\u2009years and a mean BMI of 25.07 (4.0)\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . High\u2010frequency ultrasound imaging was utilized to measure the thickness, length, and contractility of the frontal soft tissue and to determine the precise location of the line of convergence during maximal frontalis muscle contraction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The results revealed that the line of convergence was located at 58.43% (8.7) of the total forehead height above the superior border of the eyebrow cilia without a statistically significant difference between sex, age, or BMI. With frontalis muscle contraction, the forehead shortens in males by 25.90% (6.5), whereas in females it shortens only by 21.74% (5.1), with\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for sex differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrated the feasibility and practicality of pre\u2010injection ultrasound scanning for facial aesthetic neuromodulator treatments. Knowing the location of the line of convergence, injectors can determine precisely and on an individual basis where to administer the neuromodulator deep or superficial or when the injection location is at risk to cause eyebrow ptosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocd.16368","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T02:35:12Z","timestamp":1715913312000},"page":"2373-2379","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Increasing precision during neuromodulator injections for frontal rhytids\u2014Using ultrasound imaging to identify the line of convergence"],"prefix":"10.1111","volume":"23","author":[{"given":"Claudia C. B.","family":"Meneses","sequence":"first","affiliation":[{"name":"Private Practice  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio","family":"Freitas","sequence":"additional","affiliation":[{"name":"Sially Institute  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Knoedler","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Knoedler","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Davidovic","sequence":"additional","affiliation":[{"name":"Center for Radiology and Magnetic Resonance Imaging University Clinical Center of Serbia  Belgrade Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Bravo","sequence":"additional","affiliation":[{"name":"Private Practice  San Jos\u00e9 Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AmberLeigh","family":"Pappas","sequence":"additional","affiliation":[{"name":"Evolus Inc.  Newport Beach California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian S.","family":"Biesman","sequence":"additional","affiliation":[{"name":"Private Practice  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4892-2376","authenticated-orcid":false,"given":"Michael","family":"Alfertshofer","sequence":"additional","affiliation":[{"name":"Department of Oromaxillofacial Surgery University Hospital, LMU Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7210-6566","authenticated-orcid":false,"given":"Sebastian","family":"Cotofana","sequence":"additional","affiliation":[{"name":"Department of Dermatology Erasmus Medical Centre  Rotterdam The Netherlands"},{"name":"Centre for Cutaneous Research, Blizard Institute Queen Mary University of London  London UK"},{"name":"Department of Plastic and Reconstructive Surgery Guangdong Second Provincial General Hospital  Guangzhou Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"The Aesthetic Society.Aesthetic plastic surgery national databank statistics 2022. Published 2023. Accessed December 27 2023.https:\/\/cdn.theaestheticsociety.org\/media\/statistics\/2022\u2010TheAestheticSocietyStatistics.pdf"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjac116"},{"key":"e_1_2_9_4_1","volume-title":"StatPearls","author":"Biello A","year":"2023"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004836"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000006756"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.15468"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.13875"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000008708"},{"key":"e_1_2_9_10_1","unstructured":"WMA Declaration of Helsinki \u2013 Ethical principles for medical research involving human subjects. The World Medical Association (WMA). 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