Corrugator muscle excision

Question

I have very deeep 11 lines, one surgeron recommends corrugator to be excised and CO 2 resurfacing, another one says that my orbital is the dominant and he would only excised the line than CO2 and Botox treatments. My gut feeling is that it should be muscle and the line should be excised because I metabolize Botox in 4 weeks.

David K. Isaacs, MD, FACS · Answer

If you metabolize botox in 4 weeks then your injector should find another type of botox or you should find another injector. There are many different kinds of botox now and if you’ve developed resistance to one, you may not have resistance to another. Also, your injector may not be injecting into the muscle, or may not be injecting enough. I have male patients with very thick skin who even with that skin type have very creased glabellar lines that I’ve been able to get rid of their lines.

I do a lot of endoscopic forehead and brow lifts but I do not do corrugator excisions because of medialization of the brows.

I love CO2 laser but for darker skin types I will pretreat and posttreat thoroughly.

See an expert for an evaluation. Hope this helps!

I do a lot of endoscopic forehead and brow lifts but I do not do corrugator excisions because of medialization of the brows.

I love CO2 laser but for darker skin types I will pretreat and posttreat thoroughly.

See an expert for an evaluation. Hope this helps!

Nelson Lee Novick, MD · Answer

It is important to understand that there are two components to the deep eleven lines: a very forceful eleven lines muscles underneath and (after years of intense frowning muscles use) deeply etched/creases. It has long been known that combining the use of a neuromodulator, such as Botox or other others, along with the synergistic use of a low viscosity, cohesive, malleable HA Filler for the etched-in creases not only yields a much more gratifying result, but a much longer-lasting one. Daxxify, a relatively new neuromodulator begins to work sooner and the results typically last longer than those of Botox. So, this, too, can be considered before jumping into expensive surgery that carries the risk of resulting in visible scars in a very prominent cosmetic area of the face. 
You would be wise to consult with an experienced, board certified cosmetic dermatologist injection expert. Hope this helps and best of luck.

William Portuese, MD · Answer

The central component of your eyebrows are exceedingly low in addition to very active corrugator muscles with dermal atrophy. A brow lift procedure can accomplish resection of the corrugator muscles with placement of fascia grafts to help with the dermal atrophy and removal of a large portion of the corrugator muscle itself. It would also be wise to have Botox performed about a week before the surgery to weaken them further, during the healing process after the surgery. Placement of the incision at your frontal hair line can accomplish reducing the height of your forehead, and bringing your hairline down all at the same time

Corrugator muscle excision

Answers (3)

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