Removal of fat between eyebrows? (Photo)

Question

I have an extremely loose scalp, because of this i also i have what appears to be excess fat in the spot in just above my nose and just underneath my forhead. Because of this fat it makes me have the appearnce that im angry all the time when im not. Ive spoken to a few doctors with two different opionions. The first told me he could remove the fat with a small canula and the other doctor told me i would need a brow lift. Im fine with where my brows are its inbetween my brows thats the problem

Jason Emer, MD · Answer

this are is best treated with botox that llooks ilke large muscles. thermirase can help give more long term improvement here. Best, Dr. Emer.

Brian S. Glatt, MD, FACS · Answer

The area between your eyebrows that you are concerned with is not excess fat. You show strong procerus and corrugator muscles which can easily be relaxed with use of Botox. Botox is a treatment used to temporarily improve the appearance of both moderate to severe frown lines between the brows. Botox usually takes 7-10 days to reach maximum effect and lasts 3-4 months. I also encourage you to consult with a board certified plastic surgeon to discuss invasive and non-invasive treatments.

Daniel Barrett, MD · Answer

Dear timmy29,it is hard to tell for sure without an examination. I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Tim Sayed, MD, MBA, FACS · Answer

It is highly unlikely that this is fat - that simply is not a location where there is typically an anatomic fat deposit. More likely is you have thick, hyperactive male muscles in the glabella - the area between the eyebrows - which often respond will to Botox. In some cases, surgeons will actually remove these muscles as part of a brow lifting procedure, with the idea being that since these muscles contribute to a frowning, angry look and may pull downward slightly on the forehead, releasing/relaxing/removing them can open up that area and allow more upward positioning of the forehead soft tissues. I don't love removing these muscles as I'm not sure every patient who is a candidate really wants to have functioning, normal anatomic muscles excised from their bodies just to have cosmetic enhancement. I'd start with Botox - 25 to 30 units may be necessary - specific to the corrugator and procerus muscles and stay away from your mid-forehead frontalis muscle (the muscle responsible for raising eyebrows and giving rise to horizontal lines).  Later you can consider a minimally invasive brow lift approach potentially.

Jeffrey Thaxton, MD FACS · Answer

It doesn't seem to be a fat problem to me.  Botox in the procerus and corrugator muscle will likely help and may be enough.  If this doesn't fix the problem adequately then a brow lift focusing on the central forehead would address this problem and could be tailored to have a minimal effect on the brow position.  Be sure to get an evaluation by a board certified plastic surgeon.

John Sampson, MD (license obligations) · Answer

Thank you for your great question and photo. The best treatment for lines between the brows is Botox/Dysport. I would recommend treating the horizontal glabellar line (line between the brows) as well as considering a subtle brow lift with Botox.Botox immobilizes the underlying muscle at the root of the wrinkle. Within 2 days or so of treatment your expression should soften. If the line persists, you can also look into dermal fillers. Make sure you seek out someone with experience in cosmetic injectables, and look through before and after galleries before scheduling an appointment. Good luck to you!

Mats Hagstrom, MD (license on probation) · Answer

These are possible treatment options you could consider after in person consultations preferably with board-certified plastic surgeon is.
First is Botox.
Botox  of the procerus muscle and Corrugator muscles.
Do not have Botox on your central forehead or the frontalis muscle.
Next would be a partial brow lift raising your central four head only. Eyebrow lift can be tailored to lift the forehead in various places.
You may also benefit from having a radix reduction which is basically lowering the facial skeleton above the area of concern.
In order to determine the most effective treatment one must first make a proper diagnosis or understanding the ideology of why the area between your eyebrows looks the way it does.
Is this because of skeletal structure? Excessive muscles in that area or skin laxity.
I can assure you it's not an issue of excess fat.
The final option could be a direct surgical excision of what is probably normal fat and some of the muscles in the area.
My best guess without an examination is that this look is based on the shape of your facial skeleton.
If that's the case then the definitive treatment would be a treatment to reshape the bone in this area.
Continue having multiple in person consultations.
A Doctor Who performs a thorough examination at things of all of the above possibilities as a sign of someone you may want to consider getting treated by.
Add a minimum the provider should make A differential diagnosis mentioning various reasons why this looks the way it does.
Anyone who jumps to a simple conclusion that you have too much fat in the area is probably not someone you should have as your provider.
Best,
Mats Hagstrom, MD

Ronald V. DeMars, MD (Retired) · Answer

I'm not sure who told you that is fat, but that is definitely not the case and no experienced surgeon would make that diagnosis. The thicker skin in that area is folded and crumpled by overactive muscles called the procerus muscle and the corrugator muscle. A permanent solution is a variation of a brow lift not to lift the brows specifically but to cut out those muscles. You can temporarily stop the muscle function with Botox injections which work for about 3-4 months before needing to be repeated.

Removal of fat between eyebrows? (Photo)

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