I have very thick glabellar skin & what seems to be excess tissue or muscle. Botox works by preventing me to make a forrow but isn’t providing any relief to “flatten” out my thick muscles. Even with Botox, I still have these muscle bulges that make me look angry even when I’m not forrowing. Is this excess fat? Excess skin? Large muscles? What would improve this? Brow lift? Corrugator excision? Again, Botox does work by paralyzing these muscles, but the muscle bulkiness/mass/deep furrows remain.
August 23, 2018
Answer: Corrugator Hypertrophy This is a very interesting question. In general, Botox injections over a long enough period of time do cause some degree of muscle atrophy. There are interesting studies looking at muscle density on MRI after repeat Botox injections that illustrate this. A good question would be how long or how often have you been doing injections? Also, it appears from the photos provided that your corrugator muscle is quite a bit more vertically oriented than average. Usually the muscle extends out laterally with the brow, but in some cases (I believe you may be one) the muscle takes a more vertical orientation. It is possible that if the injections have been done in the "normal pattern" they may be missing the distal end of the muscle where it interdigitates with the skin, but treating the medial portion of the muscle which lays deeper. It is possible that this is contributing to the bulge effect you are seeing. Certainly the muscles can be divided in a brow lift, but care must be taken. It is important to keep in mind that there could be unwanted volume loss from this (often corrected with a graft at the time of transection) and return of muscle activity from scarring connecting the transected muscle stumps.
Helpful 1 person found this helpful
August 23, 2018
Answer: Corrugator Hypertrophy This is a very interesting question. In general, Botox injections over a long enough period of time do cause some degree of muscle atrophy. There are interesting studies looking at muscle density on MRI after repeat Botox injections that illustrate this. A good question would be how long or how often have you been doing injections? Also, it appears from the photos provided that your corrugator muscle is quite a bit more vertically oriented than average. Usually the muscle extends out laterally with the brow, but in some cases (I believe you may be one) the muscle takes a more vertical orientation. It is possible that if the injections have been done in the "normal pattern" they may be missing the distal end of the muscle where it interdigitates with the skin, but treating the medial portion of the muscle which lays deeper. It is possible that this is contributing to the bulge effect you are seeing. Certainly the muscles can be divided in a brow lift, but care must be taken. It is important to keep in mind that there could be unwanted volume loss from this (often corrected with a graft at the time of transection) and return of muscle activity from scarring connecting the transected muscle stumps.
Helpful 1 person found this helpful
August 22, 2018
Answer: Corrugator excision Corrugated or excision is usually performed as a component of a brow lift procedure when lifting low set eyebrows. The corrugator is excised, softened and divided to reduce that scowling effect like Botox. For many before-and-after brow lift examples with corrugator excision, please see the link and the video below.
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August 22, 2018
Answer: Corrugator excision Corrugated or excision is usually performed as a component of a brow lift procedure when lifting low set eyebrows. The corrugator is excised, softened and divided to reduce that scowling effect like Botox. For many before-and-after brow lift examples with corrugator excision, please see the link and the video below.
Helpful
