What are the risks of a corrugator resection? (Photo)

There are 3 options available to resect the corrugator muscles, each with its own pros and cons:1. Direct incision through upper eyelid blepharoplasty incision: this is the most straightforward approach that can be done under local anesthesia, but is slightly higher risk to damaging the nerves of sensation of the eyelid and forehead2. Endoscopic Brow lift approach- this is technically the hardest way to get to the muscles, but has the smallest incisions. Function usually does return. THis can be combined with an actual brow lift for which you might be a good candidate. However, a brow lift with this technique would elevate your hairline.3. Hairline (trichophytic) brow lift approach. I believe this is the most versatile approach: it will allow you to avoid the nerves of sensation, though the scalp will be temporarily numb. This will also allow you to remove the corrugator muscle extensively, and then place a fat graft in the area of muscle excision to minimize risk of contour irregularity and also prevent muscle function recovery. Your brows can most effectively be raised via this approach, while allow the lowering of your hairline, which seems to be high in the photos posted. This final approach is your best option, in my opinion.

There are physicians that can use an electrode to buzz the nerve to the corrugators to soften the furrows.Also, surgical disruption - such as in a Endoscopic Brow lift, Direct approach to transection, and through an upper eyelid incision all work well.

The risks are minimal in an experienced surgeon’s hands. Numbness of some of the central forehead is not unusual due to bruising of the nerves that run close to and within the corrugator but always recovers in my experience.   I have had to revise an occasional upper blepharoplasty scar I that area.   I have probably a thousand in my career.   In general it will weaken but not eliminate corrugator activity but sufficient to markedly improve frown lines.   The muscle can me more aggressively removing bed with some minor risk of irregularities which can be corrected with fat grafting.  I routinely include it as part of an upper blepharoplasty but also occasionally due as a stand alone procedure.   It can be approached through and endoscopic brow lift but it is easier through the eyelid.