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Corrugator muscle

Dr. Naderi answers your questions about all facial plastic surgery procedures, from facelift, rhinoplasty (nose job), to eyelid surgery (blepharoplasty), and dermal fillers.

Corrugator muscle

Postby tinareed » Sat Mar 17, 2007 9:01 pm

I am 5 weeks and four days out of ps and had an endo brow lift and u/l bleph. The doc cut my corrugator muscle because I frowned so bad and it was my worst complaint. Until a few weeks ago I couldn't frown. I was swollen I guess. Then it started again. The doc said just because he did an edno brow and cut a muscle doesn't mean I would not need Botox in the future or that I wouldn't have expression. He said he made me look as natural as he could (he did, I must say) but what is the use in cutting this muscle if one can use it?
lower f/l, n/l
u/l bleph
endoscopic brow lift
fat transfers to nl folds
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Postby Dr_Naderi » Sun Mar 18, 2007 8:09 am

Cutting the muscles is a good thing. Not many plastic surgeons do it during a brow lift. The ones that do are taking the time to do a better job.

But he may not have cut it completely. Even if he had cut it completely, the muscle fibers can scar and fuse back together. Sometimes, if you do Botox before your brow lift, this lessens the chances that the muscles will re-connect.

In either case, about half of the patients will not require Botox or will need much much less Botox and the other half will still need Botox.

Cutting the muscles allows for a better release of the skin and better positioning of the brows and its not just to reduce the need for Botox.

Vitamin B (Botox) is a fantastic product and not many things replace it! :wink:
www.VirginiaFacialPlasticSurgery.com

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www.RhinoplastySpecialistSurgeon.com


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Postby traci46 » Sun Mar 18, 2007 11:39 am

My corrugator was cut too, and now, it looks worse than it did before. The ps I recently consulted with told me they usually return. Why do they do it if it is going to come back looking so awful? I despair.
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Postby bichonfrise » Sun Mar 18, 2007 12:16 pm

Hmmm. Any speculation as to why there's less chance for the muscle to reconnect if given Botox prior to surgery? I know that some doctors remove this muscle, but wouldn't that alter the topography of the area and form a bit of a concavity?

What I hate most about my frown lines is the fact that they're asymmetrical.
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Postby Dr_Naderi » Sun Mar 18, 2007 6:01 pm

My corrugator was cut too, and now, it looks worse than it did before. The ps I recently consulted with told me they usually return. Why do they do it if it is going to come back looking so awful? I despair.


the reason they are cut isnt just to reduce the need for Botox but cutting the muscles releases the tension and allows the "frown to open up" and allows the brows to be positioned better.


Hmmm. Any speculation as to why there's less chance for the muscle to reconnect if given Botox prior to surgery? I know that some doctors remove this muscle, but wouldn't that alter the topography of the area and form a bit of a concavity?

What I hate most about my frown lines is the fact that they're asymmetrical.



The thought is that Botox paralyzes the muscles so in the post-op period there is less of a chance for the muscle ends to "find" each other and regain function! Its just voodoo and not solid science. But then again more than half of every single plastic surgeon's routine is not set in solid science but more in "training bias" and personal beliefs!

You are correct. excising the muscle is not smart and it can create surface irregularities.
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Postby MissJ521@aol.com » Sun Mar 18, 2007 9:52 pm

Hi Dr. Naderi,

When I had mine done, the doc said he removed the procerus muscle. (But he could just be telling me that.) I'd imagine that it would hard to physically remove the entire corrugator muscles because the fibers interconnect and weave through the medial orbicularis, frontalis and procerus. It seems like it would be hard to get out of there. I've seen Jelks demonstrate cutting it down through a small bleph incision. Mostly, he cut down the interdigitating fibers to the orbicularis, procerus and frontalis where they insert to make the offending movements. Like I did not see him pull any big pieces out of there or anything like that. There was a lot of focus on how the corrugator worked to do what and which fibers to go after. Most of them can be approached through an upper bleph incision or an endoscope in the middle of the forehead. It took some extra time and focus to do that part though.

I know one doc who won't cut the corrugator connections down. He says it displaces the medial brows too laterally.




Dr_Naderi wrote:Cutting the muscles is a good thing. Not many plastic surgeons do it during a brow lift. The ones that do are taking the time to do a better job.

But he may not have cut it completely. Even if he had cut it completely, the muscle fibers can scar and fuse back together. Sometimes, if you do Botox before your brow lift, this lessens the chances that the muscles will re-connect.

In either case, about half of the patients will not require Botox or will need much much less Botox and the other half will still need Botox.

Cutting the muscles allows for a better release of the skin and better positioning of the brows and its not just to reduce the need for Botox.

Vitamin B (Botox) is a fantastic product and not many things replace it! :wink:
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Postby Dr_Naderi » Mon Mar 19, 2007 8:07 am

You are correct. Removing the muscle is more said than done! Cutting through it to weaken it is what some surgeons do. Most surgeons dont do any muscle work because it is more time consuming and requires more skill. It also places the supratrochlear nerve and supraorbital nerves at greater risk. But it does give better and longer lasting results.
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

www.RhinoplastySpecialistSurgeon.com


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Postby MissJ521@aol.com » Mon Mar 19, 2007 9:25 am

Certainly looked like it took some specialized 'doting' on the dissection when Jelks was demonstrating how he did it to the other doctors. I would think a very 'thorough' doc would include it in the brow lift or upper bleph but I can see how others would pass on doing it or give an extra fee for including it.

I remember after my first brow lift, I said something like; 'I hope you threw my corrugator away'. The nurse lauged and said' 'ya it's in the trash can'. For a long while I could not use it but eventually, I could frown again but needed less Botox.

When I get the botox, I request total paralysis of the area. Like I dont' even want to be able to move my brows upward or medial in a frown. I like an expressionless "polker face" for the brow area. Muscle movement there expresses anger, alarm, surprise, frustration, disapproval, etc. If there is too much stuff going on around me that triggers that (like last year construction was jackhammering all day and night in front of my apartment), my face can become distorted with the repeated movements from the distressful episodes and daily personal interactions with people (even in the absense of the duressful triggers) becomes harder because they think I am MAD at THEM because the stuff can remain etched on face from prior.

Depending on the environmental circumstances, I can relax and poise my brow area myself without botox as all those movements are pretty much 'voluntary' and one can control them. But if I know a situation of duress is coming my way, I get the stuff. Otherwise, I do without it.



Dr_Naderi wrote:You are correct. Removing the muscle is more said than done! Cutting through it to weaken it is what some surgeons do. Most surgeons dont do any muscle work because it is more time consuming and requires more skill. It also places the supratrochlear nerve and supraorbital nerves at greater risk. But it does give better and longer lasting results.
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Postby Dr_Naderi » Mon Mar 19, 2007 1:58 pm

When I get the botox, I request total paralysis of the area



:shock: :shock: :shock:
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

www.RhinoplastySpecialistSurgeon.com


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Postby MissJ521@aol.com » Mon Mar 19, 2007 5:27 pm

Yup. That's what it says in my chart: "Want's total paralysis to brow"


Dr_Naderi wrote:
When I get the botox, I request total paralysis of the area



:shock: :shock: :shock:
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Postby Dr_Naderi » Mon Mar 19, 2007 5:34 pm

I'm sure Allergan is grateful for your business! :lol:
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www.VirginiaRhinoplasty.com

www.RhinoplastySpecialistSurgeon.com


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