Is it possible I have a stronger corrugator muscle on one side pulling my single vertical frown line? Is Botox right?

Question

Also my eyebrow is lower and my nose slightly crooked this side (left). Can this be due to a general facial muscle imbalance? Actually all my body is tighter on the left.

Jonathan Kulbersh, MD · Answer

Hello and thank you for your question. Yes it is possible, and even common, to have a stronger muscle on one side of the face than the other. I recommend scheduling a consultation with an experienced, board-certified injector who can examine you in person and create a customized treatment plan that addresses each muscle with the appropriate dosing amount to produce the best possible result.

Irena Karanetz, MD · Answer

Hello,
Thank you for your question.
It is common to have stronger/more animated muscles on one side vs. the other side of the face. 
Botox injections can smooth out the 11 lines/glabella (targets corrugators and procerus muscles). This typically requires 15-20 Units.
I would recommend an in person consultation with a Board-Certified Plastic Surgeon, in order to discuss your goals and concerns for the best cosmetic results. 
I hope this helps. Best regards, Dr. Karanetz
Dr. Irena KaranetzFellowship-TrainedBoard Certified Plastic Surgeon

Jason Emer, MD · Answer

muscules can be independent.  so yes you need a customized approach and botox with at home dermarolling and peels (see link) and inoffice lasers are best.

at home peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, see link) should be started now to prevent further aging.

For facial rejuvenation,  I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Yes it is possible to have asymmetric muscle function leading to differences in crease formation.  This would be treated with a higher dosing of Botox on that side and perhaps some dermal filler to improve the skins condition in that frown.

Dmitriy Schwarzburg, MD · Answer

Yes, that could be possible to have. Please contact a qualified provider or a board-certified physician with extensive experience in these procedures.

Peggy Bleezarde, MD · Answer

You have discovered the world of asymmetry. No person is completely the same on both sides. You are right and left handed. You are also controlled by different nerves from different sides of your brain to use muscles on opposite sides. Your facial muscles do not work exactly the same on each side and therefore lines can be different from side to side as well as eyebrows.  I am pleased to say there are ways to help balance eyebrows with Botox. You will need to discuss this with your injector to see how they may help balance your brows. I would suggest trying the Botox and then seeing an esthetician to shape your brows. Good luck, I’m sure you will find a good improvement.

Dean P. Kane, MD, FACS · Answer

Dear Cornelius_B,

Thanks for sharing your photo. It illustrates the natural asymmetries of human development and muscle attachments, tissue mass, bone fusion and facial expressions.

Proper evaluation of the muscle volume and strength and its activity on the frown line will determine how much botox muscle relaxation can help. Other options may include fillers and injectable sutures.

Please consult with a Board Certified Plastic Surgeon to help you decide what is best for you. 
All the best!

Kathleen Morno, MD · Answer

Great question, all muscles in our faces can have different strengths, which is why our faces don't move symmetrically. Botox can absolutely help even out your brows and relax the muscles causing the line between your brows.

Anshul Gambhir, MD · Answer

Thank you for your question! Botox would be a great option for you. We would wind up placing more botox on the side where your eyebrow is pulled down more in order to help it lift and match the other brow. Facial asymmetry is extremely common and can never be 100% corrected but it can be minimized. Hope this helps!

Samir Shureih, MD · Answer

Facial animation muscles are very different from one side to another in the same person.
That is why it is important to see a Board Certified Plastic Surgeon so he/she can evaluate the whole face and muscle function so as to personalize the Botox to the individual needs based on muscle examination and function, strength of the patient. That can ONLY be done by a plastic surgeon familiar with facial muscles function

Is it possible I have a stronger corrugator muscle on one side pulling my single vertical frown line? Is Botox right?

Answers (12)

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