Modern concepts of the blood supply to the frontalis muscle: anatomy, clinical aspects, and significance

Background. In modern aesthetic medicine, both and patients are increasingly focused on prolonging the effect of botulinum toxin therapy. It is known that elevated tissue temperatures can reduce the duration of its action. The local temperature of the forehead tissues is directly influenced by the key vascular supply points of the frontalis muscle. Objective. The aim of this review is analyzing the vascular supply patterns of the frontalis muscle reported in Russian and international publications, to enable a personalized approach to the selection of botulinum toxin injection points. This individualized approach may improve therapeutic efficacy, reduce the risk of adverse effects, and optimize clinical outcomes. Material and methods. A literature review was conducted using Russian and international databases (PubMed, Google Scholar, eLibrary). The search included analysis of titles and abstracts, followed by full-text evaluation of relevant studies. Results. A total of 55 publications meeting the criteria for scientific research were identified during the database search. The analyzed studies involved cadaveric dissection of the forehead, computed tomography, and Doppler ultrasonography on volunteers to analyze blood flow and the anatomy of arteries supplying the forehead: the so-called central (a. centralis), paracentral (a. paracentralis), supratrochlear (a. supratrochlearis), supraorbital (a. supraorbitalis), and the frontal branch of the superficial temporal artery (ramus frontalis arteriae temporalis superficialis). Each analyzed artery demonstrates individual variations in course, branching, topography, and depth of location. Conclusion. The findings demonstrate significant anatomical variability in the vascular architecture of the frontalis muscle. This information can be applied in clinical practice by aesthetic medicine specialists to achieve more effective, longer-lasting, and safer outcomes in botulinum toxin therapy.