Topographic Analysis of the Periorbital Region Including Orbicularis Oculi Muscle Based on Ultrasonography Interpretation.

Objective: Ultrasonographic examination is easy, fast, safe, and used in various fields; however, its application to the facial area has been limited. Complex anatomical structures are mixed within thin, soft tissues in the facial region; therefore, understanding their structural characteristics is crucial. This study aimed to use ultrasonography to obtain information on the layered structure and soft tissue thickness of the eye area around the orbicularis oculi muscle and provide guidance for clinical practice.

Methods: Healthy volunteers (33 men and 19 women; mean age: 28.4 years) underwent ultrasonography with nine reference points. The soft tissue thickness, including the orbicularis oculi muscle, was measured on monochromatic images. Ultrasonographic scans were performed at facial landmarks using linear transducers (IO8-17, E-CUBE15, Alpinion Medical System, Seoul, Korea), with images scanned transversely. The thickness was measured using ImageJ (National Institutes of Health, Bethesda, MD, USA).

Results: The mean thickness of the orbicularis oculi muscle was 1.56 ± 0.45 mm (range 1.03-2.31 mm). The highest thickness was measured at the points VII (2.31 ± 0.68 mm) and VI (2.15 ± 0.48 mm). The mean depth of the orbicularis oculi muscle was 1.63 ± 0.62 mm (range 0.88-2.80 mm), and the most superficial point was 0.88 ± 0.99, at point VII.

Conclusion: This study provides critical anatomical data that can enhance the precision of ultrasound-guided procedures in the periorbital area, allowing clinicians to accurately target the muscle layer and soft tissue structures. By utilizing these findings, practitioners can optimize treatment effectiveness, reduce complications, and improve outcomes in cosmetic procedures such as botulinum toxin injections, filler placements, and other non-invasive facial treatments. The detailed anatomical insights gained from this study will help bridge the gap between anatomical understanding and clinical application, promoting safer and more efficient aesthetic interventions.