More Info on Excising Currogator Muscle Please?

I love the effect botox has on my 11s, but I don't love that it is only temporary. Any details regarding corrugator myectomy (not a full brow lift) would be appreciated, i.e. type of anesthesia needed, approx costs, risks etc... Thanks!

Doctor Answers 9

Excising corrugator muscle (corrugator myectomy)

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A corrugator myectomy involves transecting the corrugator muscles through a coronal approach.  When the corrugator muscles are extremely hypertrophic and/or if dermal atrophy is present with the 2 vertical lines between the eyebrows, fascia grafts are placed between the muscle and the dermis to prevent the dermal atrophy from recurring.  This can be done without lifting the eyebrows.  This is done under general anesthesia with a brow lift procedure.  The cost is around $6000, which includes the operating room, anesthesia, and surgeon’s fee.

Removing the corrugator muscle vs Botox

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Botox is very effective in relieving the frown lines caued by the corrugator muscles, however, it is temporary, lasting about 3-4 months.

Excising the muscle can be performed through a forehead incision during a brow or forehead lift or it can be removed through an upper eyelid incision. The latter is usually done during an upper eyelid lift, called a blepharoplasty. I have also removed them successfully through the actual wrinkles. It is very difficult to remove all of the muscle, however. The muscle can be diminished to the point that the result is satisfactory in most cases.

A problem I have seen rarely, fortunately, is too much subcutaneous tissue being removed in an attempt to remove the corrugators, and this leaved a depression in the forehead just above the nose. The operating surgeon must know his anatomy to effectively remove only the muscle and not the surrounding tissues to avoid this.

When a patient gets "injection fatigue," a corrugator muscle excision is a good option in my opinion. If Botox is needed afterwards, it should be only rarely, if at all.

BOTOX for brow lifitng vs excising the corrugator muscle

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Excising the corrugator muscle is usually only done as part of a brow lift. Some surgeons do it as part of blepharoplasty. It is surgery and can cause irregular contour because you’re excising the muscle. If you just weaken the muscle often, the action of it will come back. In general using BOTOX is a much better approach as surgery may not be permanent and may cause further damage. BOTOX over time tends to decrease the lines and when combined with filler can give a very long lasting result.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon

Corrugator Myectomy versus Botox

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Myectomy (excision of the muscle) has certain problematic factors which include reattachment of the muscles , thinning of the skin, which allows the wrinkles to be reformed. Botox or Dysport are great alternatives for this procedure as they are highly effective in treating the 11's and with continued injections you may see less need of frequency with very successful results, minimal downtime and no surgery. Best regards.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 214 reviews

Glabellar Myectomy Not As Effective As Botox

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Weakening or denervation of the glabellar musculature can be achieved but cutting/excision of the muscle. While initially done through endoscopic approach, it is more effective when done directly through an upper eyelid incision. While some redeuced muscle action can be achieved on a permanent basis, it will not have the same effect as Botox injections which effectively treat a larger surface area of muscle.

I wouldn't recommend it

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Inevitably no matter how aggressive you are, the muscle function seems to want to come back. In addition mroe aggressive dissection can lead to potential complications such as contour deformities and skin necrosis. If BOTOX works, I would stick with that.

Samson Lee, MD
Seattle Facial Plastic Surgeon

Excising the Corrugator Muscle to Eliminate Glabellar Frown Creases

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The easiest way to treat the corrugator muscle to eliminate or decrease the vertical forehead creases is to approach the muscle through an upper eyelid incision. However, this is not 100% successful because it  difficult to remove all fibers. Botox may still be necessary after this procedure. The most significant risk is the possibility of a depression and contour irregularity after muscle removal. Interruption of the muscle, rather than excision, is not as effective, but is safer.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Corrugator Muscle Removal

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The procedure is easily done through an upper eyelid incision and can be done with local or general anesthesia. Prices vary around the country so check with your local surgeons. Even with a resection of the muscle there may still be a few fibers left and you may not get as total a relief as you get with Botos.

Myectomy defects

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myectomy(excision of muscle) was a popular procedure prior to the widespread use of botox and dysport

it was common to excise the muscle only to find minute remaining fibers of muscle re-attatching and the wrinkle returned.  the procedure was then refined to place a sheet of gore-tex in the muscle bed to prevent fiber re-attatchment, but the muscle fibers still reformed the wrinkles

frequently the patients would develope thinning of the skin with a noticable defect.

a technique of muscle resection will be developed to overcome these problems but beware

David V. Martini, MD
Elkton Facial Plastic Surgeon

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.