Corrugator (Or Some Other) Muscle in Wrong Location? (photo)

Direct brow lift two years ago (corrugator muscles were excised/had glabellar muscle ablation) I’ve notice on the medial portion of the orbit on my right eye it feels a bit thicker and when I furrow my brow there is a muscle in that location that moves accordingly (can feel with fingers).Is it possible the corrugator or some other muscle somehow migrated or grew back into that location? I’ve looked at countless facial muscle diagrams and it doesn't seem that muscle should be there. Thoughts?

Doctor Answers 6

Abnormal Movement 2 Years After a Brow Lift is Likely Due To your Post-Surgical Musculature

There are 2 things we see after a brow lift with muscle excision. First, one of the muscles was not completely excised. This leaves more fullness on one side as compared to the other, and changes the way that muscle moves, often giving an unusual bulge, wrinkle, or expression. Secondly, in response to the change in musculature caused by the surgery, other muscles in the area will try to "pick up the slack", causing unusual movements and odd expressions. The most likely answer to your situation is not found on any of Netter's diagrams as your anatomy was changed when you had the surgery. A little bit of Botox by a very experienced injector may help with your issues. Good luck.

Greenwood Village Facial Plastic Surgeon
4.4 out of 5 stars 26 reviews

Brow Asymmetry After Direct Brow Lift

The most likely answer to your question is that some residual functional corrugator remains on the right side.  The purpose of any form of brow lift is to soften expression, but not to remove motor nerve supply. Even in circumstances of very aggressive corrugator disruption, glabellar activity can return with residual muscle.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 reviews

Corrugator (Or Some Other) Muscle in Wrong Location?

    The muscle has reinnervated and/or reattached after a period of time and is causing the distortion.  Botox to this area would be the most economical and predictable treatment.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Corrugator function can return

When corrugator muscle is excised, it is not uncommon for the function to return down the road. One way we combat this possibility is by placing a fat graft in the area where muscle was excised. This will lessen the likelihood that the muscle will reapproximate and recover function.

At this point, using botox focally to areas of unusual movement is your best bet.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

Corrugator (Or Some Other) Muscle in Wrong Location

After undergoing a direct brow lift some muscles may re-innovate and you may have some unusual looking muscle patterns.  It could be because some of the muscles were weakened during the brow lift and now they’ve become stronger again.  This can cause an irregularity and a thickening on one side.  This can often be improved with Botox to weaken the muscle.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 66 reviews

Corrugator (Or Some Other) Muscle in Wrong Location?

Your corrugator is (was) likely in the normal position. What will typically happen is that if the muscle is incompletely excised that the ends can essentially scar together and begin functioning again down the road. This is more common following endoscopic browlift procedures but could have also occurred in your case. Also, resecting tissue in that area can lead to a contour deformity (bump or divot) due to tissue removal. If the movement concerns you then Botox would be a great option to address the muscle activity.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.