Fundamentals of Skull Anatomy for Aesthetic Physicians

In aesthetic medicine, understanding cranial anatomy is essential for performing safe injections and achieving natural results.   
Many professionals begin applying techniques without a deep knowledge of bone structures, which can limit precision and increase the risk of complications.

In our theoretical class prior to hands-on training, we start by reviewing the anatomy of the skull, covering the base bones, sutures, foramina, and their clinical relevance in treatments such as dermal fillers, botulinum toxin, and non-surgical rhinoplasty.

The Importance of Understanding the Bony Foundation

The skull acts as the foundation on which muscles, blood vessels, and soft tissues rest. Most of the landmarks used by professionals when injecting are related to bony structures. Knowing where the bones are and how they connect allows practitioners to:

• Increase safety by avoiding high-risk blood vessels
• Achieve more harmonious aesthetic outcomes through proper projection
• Optimize injection technique, especially in areas such as the cheeks, nose, and jawline

Key Skull Bones and Their Clinical Application

Frontal and Parietal Bones  
The frontal bone, located at the upper and front part of the skull, forms the forehead and orbital region. It connects to the parietal bones via the coronal suture. These bones are relevant when performing deep botulinum toxin injections to soften horizontal forehead lines.

Zygomatic Bone (Cheekbone)         
This is the primary bone targeted for cheek filler treatments. Injecting on the bony surface of the zygoma allows for facial projection and support without excessive superficial volume.

Maxilla and Mandible          
The maxilla is the central bone of the face, crucial for treating the nasolabial fold and correcting tear troughs by working on the orbital rim.
The mandible and its gonial angle are key in defining the jawline. The chin (mental foramen area) is commonly treated with hyaluronic acid for projection but must be approached with caution due to vascular structures.

Nasal and Lacrimal Bones    
The nasal bone is the foundation for non-surgical rhinoplasty procedures.
The lacrimal bone, located in the orbit, is connected to the tear trough area and is one of the most delicate zones in under-eye treatments.

Temporal and Sphenoid Bones       
The temporal bone is located in the temple region. Temporal lifting techniques often target the parietal area, but caution is necessary due to the superficial temporal artery.
The sphenoid is one of the most complex bones, serving as a connection point for multiple skull structures.

Sutures and Anatomical Landmarks

Sutures are joints between bones and act as anatomical "maps." The most relevant ones include:

• Coronal suture (frontal-parietal)
• Lambdoid suture (parietal-occipital)
• Frontozygomatic suture (useful for locating the zygomatic arch)
• Zygomaticomaxillary suture (essential for understanding the transition from cheekbone to mid-cheek)

Knowing these lines helps in precisely identifying injection points on the bone.

Foramina and Risk Areas

Foramina are openings in the bone through which arteries and nerves pass. Identifying them is essential to avoid intravascular injections:

• Supraorbital and supratrochlear foramina – related to forehead vascular supply
• Infraorbital foramen – located under the eye, associated with the infraorbital artery
• Mental foramen – located in the chin, a key area for chin projection with filler

Injections should be avoided directly over these sites unless using advanced techniques, such as cannulas, to reduce the risk of necrosis or vascular complications.

Procedures and Bones Involved

Each aesthetic technique is based on specific bony structures:

• Botulinum toxin for the forehead – involves the frontal bone
• Nonsurgical rhinoplasty – on the nasal bone
• Cheek fillers – on the zygomatic bone (anterior or lateral projection)
• Jawline contouring – on the gonial angle and chin
• Tear trough correction – involves the orbital rim, especially of the maxilla

Conclusion

Bone anatomy is the foundation of safe and effective aesthetic injections.
Understanding the location of each bone, suture, and foramen enhances injection technique, reduces complications, and delivers more natural results.

At CIME Academy, we offer specialized training for doctors seeking to refine their skills in hyaluronic acid fillers, botulinum toxin, and other advanced techniques—always with a strong focus on anatomical safety and aesthetic excellence.

Write to us now and secure your spot in the next Hyaluronic Acid Filler Course.

Location: Calle Entenza Nº 144, 08929 Barcelona – Clínica CIME Barcelona
WhatsApp: +34 690 864 816
E-Mail: secretaria@cimeacademy.com