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Updated: Mar 18, 2026

Functional Evaluation of Biological Neurotoxins in Networked Cultures of Stem Cell-derived Central Nervous System Neurons
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Glabellar Contraction Patterns and Neurotoxin Efficacy: A Quantitative Assessment.

Salman Khan1,2, Mehdi Lemdani2,3, Malia Voytik2,4

  • 1University of Pennsylvania, Perelman School of Medicine.

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|March 16, 2026
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Summary

Glabellar frown line patterns impact neurotoxin treatment duration. Customized injections targeting specific muscles may improve outcomes for patterns O and IO, which show shorter-lived results.

Keywords:
glabellaglabellar contracture patternsneurotoxin

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Area of Science:

  • Aesthetic medicine
  • Dermatology
  • Facial anatomy

Background:

  • Standard glabellar frown line treatment uses a fixed 5-point neurotoxin injection technique.
  • Patient muscle recruitment patterns vary, influencing treatment efficacy.
  • A classification system exists for glabellar patterns (U, V, O, IO, CA), but its impact on outcomes is unquantified.

Purpose of the Study:

  • To quantitatively assess the influence of glabellar anatomical patterns on neurotoxin efficacy.
  • To evaluate the duration of neurotoxin effects based on distinct glabellar contracture patterns.

Main Methods:

  • 142 women received standardized 5-point neurotoxin injections.
  • Patients were classified into glabellar patterns (U, V, O, IO, CA) based on muscle recruitment.
  • 3D strain analysis (Vectra M3) measured dynamic strain at multiple time points post-injection.

Main Results:

  • Significant baseline strain differences were observed among patterns (P=0.029).
  • All patterns showed strain reduction by 90 days; U and CA remained improved at 180 days.
  • Patterns O and IO had shorter-lived improvements and higher residual strain.

Conclusions:

  • Glabellar contracture patterns significantly influence neurotoxin efficacy and duration.
  • Patterns O and IO benefit from customized injection protocols targeting additional muscles.
  • Tailoring treatments to individual glabellar anatomy can enhance patient outcomes.