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Digital Image Correlation

A Novel Dynamic Three-Dimensional Imaging Technique for Precise Quantification of the Dynamic Rhytid and Botulinum Toxin Type A Efficacy

Wilson, Anthony J. M.D.; Chin, Bianca C. M.D.; Hsu, Vivian M. M.D.; Mirzabeigi, Michael N. M.D.; Percec, Ivona M.D., Ph.D.

Plastic and Reconstructive Surgery: May 2015 - Volume 135 - Issue 5 - p 869e–876e
doi: 10.1097/PRS.0000000000001224
Cosmetic: Special Topics
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Background: Quantification of facial dynamic motion is paramount for improving cosmetic and reconstructive surgical outcomes. The authors introduce digital image correlation using speckle tracking photogrammetry and Aramis software (GOM mbH, Braunschweig, Germany) to study facial dynamics and demonstrate its application in quantifying botulinum toxin efficacy.

Methods: Fourteen subjects were evaluated using a dual camera system and three-dimensional optical analysis. Using Aramis software, the anatomic regions of the glabella, forehead, and total face were identified and highlighted. Tissue strain, defined as either compression or stretch, was measured within these regions over 36 frames during brow furrowing. Each patient was measured before and 2 weeks after injection of 20 units of onabotulinumtoxinA in the glabella. Average stretch and compression in treated areas were analyzed across all available frames. Results were compared using a Wilcoxon signed rank test.

Results: After neurotoxin injection, average vertical stretch of the glabella during brow furrowing decreased from 2.51 percent to 1.15 percent (p < 0.05), and average vertical stretch in the forehead decreased from 6.73 percent to 1.67 percent (p < 0.05). Horizontal compression in the glabella decreased from 9.11 percent to 2.60 percent (p < 0.05) and from 4.83 percent to 0.83 percent (p < 0.05) in the forehead. Total facial major strain decreased from 4.41 percent to 3.05 percent (p < 0.05), and total facial minor strain decreased from 5.01 percent to 3.51 percent (p < 0.05).

Conclusions: The authors introduce digital image correlation as a novel technology for measuring dynamic rhytid and neurotoxin efficacy. This technique allows for advancements in the study of dynamic aging and neuromuscular disorders.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, II.

Philadelphia, Pa.

From the Division of Plastic Surgery, University of Pennsylvania.

Received for publication June 17, 2014; accepted October 10, 2014.

Presented at the 93rd Annual Meeting of the American Association of Plastic Surgeons, in Miami, Florida, April 5 through 8, 2014, and the Aesthetic Meeting of the American Society for Aesthetic Plastic Surgery, in San Francisco, California, April 24 through 29, 2014.

Disclosure: The authors have no financial disclosures to report. All drugs and devices were obtained through an institutional grant; no industry funding was provided.

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Anthony J. Wilson, M.D., 3400 Spruce Street, 10 Penn Tower, Philadelphia, Pa. 19104, anthony.wilson@uphs.upenn.edu

©2015American Society of Plastic Surgeons