Endoscopic forehead lift - is it safe to remove muscles?

Question

I have a saggy brow and my doctor suggested endoscopic forehead lift. He said by resecting some unnecessary muscles like corrugetaor Supercilli, i can lift my eyebrow. But is it safe to resect muscle?

Jonathan Kulbersh, MD · Answer

This is a great question.  I believe patients and sometimes doctors forget about the "art" of plastic surgery.  There is not a correct answer to this question because different artist will have different opinions of the results of removing or cutting the muscles in the forehead during a endoscopic forehead lift.  There are good points for argument to do the following to the forehead muscles:1)  Remove muscles2)  Cut muscles3)  Leave the muscles aloneYou need to find out the reason why a surgeon chooses his choice.  I choose not cut or remove the muscles.  The reasons why are:1)  Less risk of a complication2)  Less risk of changing the width between the eyebrow3)  Less risk of causing a contour irregularity4)  Less risk of nerve damage5)  Overall do not love the aesthetic change of cutting the muscle6)  Full muscle movement may come back with just cutting the muscleOther doctors may disagree with me, and I would understand.  I hope this helps.

James Bonaparte, MD, MSc, FRCSC · Answer

Thanks for the question, an endoscopic forehead lift requires some release of muscles. Its a complicated issue however, if you want to try to get an understand of it,  check out the link I posted. Its a 3 part blog all about forehead and eyebrow lifts. You may find it usefull. Dr James P. Bonaparte

John J. Martin, Jr., MD · Answer

When doing an endoscopic browlift most surgeons do something to weaken the muscles.  This is often just severing the muscles where they attach.  Other surgeons may remove the muscle.  The only risk here is that some patients may develop a depression in the glabella where the muscles had been.  You then have to fill this area with fat or filler.

Curtis Wong, MD · Answer

can lead to migration of your brows laterally if done too aggressively.  But it will remove your ability to frown.  So you kinda have to choose one or the other as your preference and hope your surgeon can get it perfect for you.

David Q. Santos, MD · Answer

Experienced endoscopic plastic surgeons will provide safe forehead surgery.  Trimming the muscles (corrugator supercili, procerus and frontalis muscles) is helpful in achieving a good result.  It is not always required to address he muscles but when done effectively and when done by an experienced surgeon the results can be very pleasing.

George Orloff, MD, FACS · Answer

The corrugator  and procerus muscles are two small muscles that pull DOWN your brow.  The are small and located between the midline and the brow, next to the nose. They cause the 11's between your brows above the nose.  Both muscles are usually treated in some fashion during a coronal or endoscopic brow lift.  Treatment may involve cutting or resecting a piece or both (sometimes they are left alone depending on what you are trying to accomplish). Treatment of the muscles will not affect your ability to lift your brows.  Ask your surgeon to explain this portion of the procedure in greater detail to alleviate your concerns.

Barry L. Eppley, MD, DMD · Answer

It is common and perfectly safe to remove some of the muscle in the glabellar region during an endoscopic browlft. They are just muscles of facial expression and their loss poses no adverse functional issues.

William Portuese, MD · Answer

When performing a brow lift procedure one of the goals  is to weaken the depressor muscle of the  forehead called the corrugator muscle. It's important not to remove all of it, just soften the expression which accomplishes weakening depressor function of the forehead muscle in addition to weakening the scowling ability. Removing all the muscle will leave the patient without any animation. The frontalis muscle  of the forehead can also be softened which creates the horizontal wrinkles across the forehead. Other issues are addressed at the time of the brow lift are asymmetry of the eyebrows, raising or lowering the hairline, and raising low eyebrows when present.

Ben Talei, MD · Answer

If the surgeon performs this often it is very safe. The removal of muscle from that approach isn't an issue.  Dissection around the nerves that give you sensation is but patients rarely have an issue with this after the initial healing.   When removed from an eyelid approach the deficit of muscle can leave a little divot in the skin, but through a brow lift approach this rarely happens.  It's a good option for someone with heavy furrows or heavy medial brows.

H. George Brennan, MD, FACS - Account Suspended · Answer

Resecting muscles has potential hazard and can lead to significant nerve and muscle disfunction as well as contour deformity. It can also result in a "frozen" forehead that appears to have absolutely no expression. There are safer more predictable methods. Confirm with a real expert in a non-endoscopic brow repositioning which also treats the central forehead muscles. Good luck

Endoscopic forehead lift - is it safe to remove muscles?

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