Grants We Funded

Abstract
The effects of Botulinum toxin treatment on facial musculature have previously relied upon subjective, qualitative patient- and physician-reported outcomes. We seek to apply a novel quantitative metric in a prospective observational study. Digital Image Speckle Correlation (DISC) analysis is a non-invasive, sensitive technique that quantifies facial muscle recruitment by detecting subtle deformations of the overlying skin. A photo is taken of a patient volunteer with the face at rest and during a slight facial movement, and the software calculates the force of contraction. DISC quantifies the initial paralysis of each individual muscle group and monitors their return of function over time. Botulinum toxin injections will be dosed to cosmetic effect in the forehead, glabellar, and crow's feet areas. Photos will be taken of patient volunteers immediately before and after treatment using a head stabilizer that standardizes position and distance from the camera, with their faces at rest and then raising their eyebrows, frowning, and blinking. This series will be repeated at one week, two weeks, four weeks, and monthly to six months follow-up. DISC software will then be used to calculate the contractile force of the facial muscles initially and at each subsequent follow-up visit, comparing to the baseline to determine the percentage change over time. We will corroborate our quantitative analysis with patient-reported data using the validated FLO-11Questionnaire and SPA Measure, as well as SGA and FWS scored by plastic surgeons. DISC is a sensitive, non-invasive measure of facial muscle dynamics that provides a novel approach to quantitative, prospective outcomes data to Botulinum toxin treatment. It has the potential to enhance clinical judgment in tailoring treatment to individual patients. Additional applications of this technology include monitoring recovery following nerve repair, or quantifying prospective outcomes data for facial transplant recipients.