Advertorial: The Glabellar Types and How to Assess Them

14 Aug 2023

Glabellar lines are not just about the classic ‘11s’ shape... Dr David Eccleston explores five different types of patterns and what this can mean for evolving your clinical practice

Addressing patients’ concerns about their lines and wrinkles is a mainstay of most aesthetic practices.

But what if you could take your consultations to the next level by stepping away from the cookie-cutter approach and refining your recommendations to match the unique differences in the way these lines form in each of your patients?

An individualised approach

In the past, studies focused on the glabellar complex typically described a standard approach to assessment that doesn’t take into account individual anatomical differences.

Yet as our understanding of anatomy has evolved, so too has the knowledge that variations in muscle contractions differ between patients. Five types of glabellar contraction patterns were first published by Ada Regina Trindade de Almeida et al.1

The understanding of anatomy makes way for a more personalised rather than one-size-fits-all approach.

Dr David Eccleston, Medical Director of MediZen, explains, “When considering various types of lines anywhere in the face, we know that broadly speaking, the origins of muscles, where they sit and how they work are similar. Yet how each person uses those muscles is as unique as they are. That’s why it’s important to understand the differences in the movements of muscles to gain a deeper understanding of anatomy and unlock new ways to evolve your clinical practice.”

Five glabellar contraction patterns

  1. U – U-shape
  2. V – V-pattern
  3. →← – Converging arrows
  4. Ω – Omega
  5. Ω – Inverted Omega

The two most common contraction patterns identified were the V and U shapes.1

The V pattern

The V-type glabellar line contraction pattern was identified as the most frequent type, seen in 32% of cases.1 “It is a more profound movement”, says Dr Eccleston. “At rest, the eyebrows tend to be more horizontal or rectified and lower. And due to increased involvement with the procerus muscle, the medial brow tends to be pulled down more than in the U type of contraction.”

U shape

The U shape was identified as the second most common type of glabellar line, found in 27% of the study cases.1 The muscles most often involved are the procerus and corrugators. “With the U shape, we tend to see approximation and depression of the space between the eyebrows with variable intensity but generally little range”, says Dr Eccleston. “As a result, the movement takes the form of the letter U. At rest, the eyebrows tend to form an arch.” 

Evolus and Dr Eccleston have partnered to create a 30-minute course of bite-sized educational and promotional videos, specifically for healthcare practitioners to explore the five glabellar types. The videos explore ideas that may influence your assessments and enhance your clinical practice.

Expand your knowledge

In summary, a deeper understanding of the different anatomical features helps to define an individual patient’s expression. Classifying glabellar lines makes the identification of the prevalent contraction patterns easier, which can enhance the consultation about treatment approaches that may suit.1

Evolus: your virtual guide

Sign up to the Evolus Service Platform at Dr Eccleston will be your guide to the five glabellar types. He’ll take you through the impact of anatomy and muscle contraction to the appearance of glabellar lines so that you can view your patients through a different lens. For treatment guides and much more, join the community.

This advertorial was written and commissioned by Evolus.

Preparation date July 2023 | UK-UNB-2300080 

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