Possibilities of MRI in assessment of changes in the anatomy of the orbilus oculus muscle following facial invasive cosmetic and surgical interventions

Objective. Evaluation of the capabilities of magnetic resonance imaging (MRI) in studying changes in the anatomy of the orbicularis oculi muscle during invasive cosmetic and surgical interventions in the facial area. Material and methods. The study included 95 patients examined at Sechenov University Clinical Hospital No. 1 in 2025, 55 of them had wide range of complaints after invasive facial cosmetic and surgical interventions. The patients were divided into three groups: Group I consisted of patients who had undergone dermal filler injections (n=43; 45%), Group II — patients after blepharoplasty and lipofilling (n=12; 13%). The third group (III) of 40 patients (42%) served as a control group. All patients (100%) underwent magnetic resonance imaging (MRI) of the facial soft tissues at the radiology department No. 2 using a Siemens Magneton Aera MRI system (Siemens, Germany). The criteria for evaluating the orbital part of the orbicularis oculi muscle in MRI were: 1) visualization of the muscle in the supra- and infraorbital areas; 2) symmetry relative to the contralateral side; 3) shape and contours of the muscle; 4) visualization of the muscle along its entire length, presence of thinning or defects; 5) homogeneity of the MR signal from the muscles; 6) presence of foreign inclusions within the muscle, above or below the muscle; 7) condition of the surrounding soft tissues, in particular fat tissue. Results. In all 40 patients (42%) from the control group the orbital part of the orbicularis oculi muscle was differentiated in the supra- and infraorbital areas, visualized along its entire length, arcuate in shape, with clear smooth contours, with a hypointense MR signal on T2-WI and T1-WI, no areas of thinning, defects or the presence of foreign inclusions were detected. When analyzing patients of group I (n=43, 45%) after contour injection plasty, the orbital part of the orbicularis oculi muscle was intact in 20 cases (21%), in the remaining patients (n=23, 24%) there was asymmetry, thinning and defects of the orbicularis oculi muscle. In 14 patients (18%) foreign inclusions were determined within the muscle, above the muscle — in 15 patients (16%), under — in 4 patients (4%). MRI signs of edema of surrounding fat tissue were detected in 7 patients (7%), fibrous changes — in 13 patients (14%). When analysing the group II with patients after blepharoplasty and lipofilling (n=12; 13%), the orbital part of the orbicularis oculi muscle was intact in 3 cases (3%). In the remaining patients (n=9, 9%), asymmetry, thinning and defects of the orbicularis oculi muscle were noted. In 6 patients (6%) lipofilling was performed, and in 3 patients (3%) contouring of the fat tissue was noted, in 1 patient (1%) — MRI signs of lipogranuloma, in 2 patients (2%) — accumulations of fat tissue were determined within muscle. MRI signs of edema of surrounding fat tissue were detected in 4 patients (4%), fibrous changes — in 9 patients (9%). Conclusion. Magnetic resonance imaging allowed in 100% of cases to visualize the orbital part of the orbicularis muscle in patients of all three groups. At the MR-study the following criteria were developed for the detailed assessment of the orbital part of the orbicularis muscle: visualization in the supra- and infraorbital areas, symmetry, shape and contours of the muscle, visualization of the muscle along the entire length, presence of thinning or defects, uniformity of the MR-signal, presence of foreign inclusions in the thickness of the muscle, above or under the muscle, the condition of the surrounding soft tissues. According to the results of MR-assessment of the orbicularis oculi muscle, patients of groups I and II predominantly had asymmetry, thinning, and defects of the muscle, while in group I, foreign inclusions were found in the muscle thickness after contour injection plasty, and in group II, fat inclusions after lipofilling. The proposed assessment algorithm allowed to identify changes in the anatomy of the orbicularis oculi muscle after the performed interventions in all patients.