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Introduction

If you have deep frown lines between your eyebrows, you are not alone. In fact, this area (the glabella) is the most commonly treated area for Cosmetic Botulinum toxin (BOTOX®) injections. As demonstrated by its huge worldwide success and popularity, BOTOX® Cosmetic works extremely well, but it has one major downside: it only lasts 4 months at a time. If you are looking for an alternative to having BOTOX® injections every 4 months, you should consider Corrugator Muscle removal.

What Does Corrugator Removal Accomplish?

The corrugator muscles sit just below the skin, roughly in line with the inner eyebrows. Together, the paired muscles form a “V” shape. When you frown, the muscles contract, making vertical frown lines (’11 lines’) that are similar to an accordion when it is compressed. BOTOX® works by freezing the muscles on a temporary basis. Corrugator Removal is a surgical procedure that actually takes away a portion of the muscle rendering it weaker and ineffective. This has the effect of a permanent improvement of the frown lines.

Do I Need Frown Line Removal?

There are usually two types of patients who seek Corrugator Removal:

  • Patients who want a more permanent removal of wrinkles between the brows
  • Patients who have very strong muscles that do not have a good response to BOTOX®, or require increased BOTOX® dosing

Important Considerations About Corrugator Removal

Commonly Performed with Upper Lid Blepharoplasty

Corrugator Removal can be done on its own but is more commonly done in conjunction with an Upper Blepharoplasty procedure, since the access to the corrugator muscles is through an incision almost identical to that of an Upper Lid Blepharoplasty.

Some Movement May Still be Present

You may still have some weak movement of the muscles after the surgery, and it is more common in patients with large muscles. The reason for residual movement is due to the fact that some important sensory nerves travel through the corrugator muscle. When corrugator removal is being performed, the nerve is preserved so that sensation of the forehead directly above the brows can be maintained. Preservation of the nerve involves leaving a portion of muscle intact which contributes to the residual movement. Most patients actually prefer some subtle movement however, because it is more natural.

Already Included in a Brow Lift

If you are considering a Brow Lift, weakening of the corrugator muscle will be performed as part of the Brow Lift procedure, providing the same effect (although not performed in the same manner). Thus, Corrugator Removal is not necessary if you plan to have a brow lift.

How to Choose the Best Plastic Surgeon For You

Incisions

The incision is along the upper lid crease. This is principally the same incision used for Upper Lid Blepharoplasty but it is not as long when performing isolated Corrugator Removal. Typically, eyelid incisions heal very nicely with almost imperceptible scars. This occurs because the eyelid skin is so thin.

The Corrugator Removal Procedure

Toronto plastic surgeon Dr. Lawrence Tong performs your surgery, within the private CPSO accredited surgical facility, St. Thomas Surgical Centre. The surgery suite is conveniently located in the same building as Dr. Tong’s office at 7 St. Thomas Street, near Bay and Bloor in the Yorkville district. You may undergo the procedure under IV sedation or general anesthetic. With general anesthesia, you will be asleep and unaware of your surroundings. If the surgery is performed under IV sedation, you will not be asleep but feel drowsy and relaxed, with local anesthetic placed in the area to eliminate pain and discomfort.

The procedure starts with the incision along the upper lid crease. Through this incision, Dr. Tong performs dissection towards the area of the corrugator muscle, under the area of the inner eyebrows. The muscle is identified and carefully removed bit by bit. Once Dr. Tong removes an adequate amount of muscle, he does the other side. The incisions are then meticulously sewn shut and the procedure is complete.

Recovery After Corrugator Removal

Recovery Immediately After Corrugator Removal Surgery

After your Corrugator removal procedure, our medical staff will transfer you to the recovery area, where our nurses monitor you until the anesthetic wears off completely. This process takes approximately one hour before you are allowed to go home, accompanied by a family member or friend.

Recovery at Home After Corrugator Removal Surgery

At home, you should rest and adhere to non-strenuous activities. Because you have had surgery around the eyes, refrain from reading or watching TV in the immediate postoperative period. After 1-2 days you will likely feel well enough to go back to work, although you may still have swelling and bruising around the eyes at that time.

Follow up After Corrugator Removal Surgery

You will see Dr. Tong again one week after your surgery and your stitches will be removed. Strenuous activity is generally permitted at 4 weeks. Dr. Tong will see you again at 6 week, and 6 months after surgery. Photographs are taken at those times to document your progress.

Like any procedure, Corrugator Muscle Removal has risks and complications associated with it. The risks are low, but do exist. At your consultation, Dr. Tong will go over the pertinent potential risks and complications associated with Corrugator Removal.

Your Corrugator Removal Consultation in Toronto

Do your research before deciding on whether surgery is right for you. During your consultation, you will have Dr. Tong’s undivided time, and you will never be rushed. There is a great deal of information to absorb, and Dr. Tong will make sure that you understand all the important details. Our goal is to educate you about your rejuvenation options. We know that an educated patient will make better choices about their surgery and their surgeon.

To learn more about how Dr. Tong can permanently improve the frown lines between your brows, set up a consultation with Dr. Tong by giving us a call at (647) 931-1287. Alternatively,let us give you a call; just fill out our contact form and we will call you on the same or the next business day. No doctor’s referral is needed.

Frown Line Removal at a Glance

What the procedure does
Eliminates frown lines (between eyebrows) by removing the muscle that causes the wrinkles
Duration of the result
Permanent
Length of time to perform the procedure
45 minutes
Type of anesthetic most commonly used
IV sedation or general anesthesia
Length of time off of work
5-7 days
Time to get back to exercise
2 weeks for light excercise, 4 weeks for heavy exercise
Pitfalls your Plastic Surgeon should avoid
  • Numbness of the forehead from nerve injury
  • Contour depression in the area from over resection of muscle

Dr. Lawrence Tong has either authored or reviewed and approved this content.

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