Is the addition of corrugator and procerus myectomy to browlift procedures associated with improved outcomes?
In this comparative cohort study of 23 patients who underwent browlift surgery with or without corrugator and procerus myectomy, the browlifts with muscle resection were associated with superior glabellar wrinkle reduction compared with the browlifts without muscle resection.
In browlift procedures, the incorporation of corrugator and procerus myectomy may result in improved aesthetic outcomes in the glabellar region.
Glabellar wrinkling is a critical component of upper facial aging.
To compare the long-term outcomes on the wrinkle lines of the glabella and forehead following browlifts with vs without corrugator and procerus muscle resection.
Design, Setting, and Participants
A prospective cohort comparative trial was conducted of 23 patients who underwent browlift procedures by a single surgeon at a single institution (16 with glabellar muscle resection and 7 without muscle resection) between May 1, 2016, and July 1, 2017. All analysis took place between May 1, 2016, and May 14, 2018. The mean follow-up period was 16 months (range, 12-21 months). Sixteen of the 23 patients underwent a browlift with muscle resection procedure alone or in combination with other facial rejuvenation procedures to the brow, midface, jowl, and neck. Four of the 23 patients underwent browlifts only, and 19 had browlifts with other procedures. Seven of the 23 patients had browlift procedures without muscle resection and were designated as controls.
Endoscopic browlift surgery was performed either with procerus and corrugator muscle resection or without muscle resection.
Main Outcomes and Measures
Neutral gaze and dynamic photographs of the upper face obtained preoperatively and after the 1-year postoperative mark were reviewed and scored in a blinded fashion by 2 physicians not affiliated with the study team using a modified Fitzpatrick Wrinkle Assessment score (FWA; from 0 [no wrinkling] to 5 [deep wrinkling with redundant skin]).
The 23 study patients had a mean age of 60 years (range, 48-74 years); 21 were women, and 2 were men. There was a significant difference between the myectomy and control groups in the 12-month postoperative improvement in dynamic glabellar FWA scores (2.56 vs 1.07, P = .01). There was a difference between the myectomy and control groups in the improvements in resting glabellar FWA scores at 12-month follow-up, but it did not reach statistical significance (1.28 vs 1.00, P = .38). The 12-month postoperative improvements in dynamic (1.19 vs 1.29, P = .86) and resting forehead (1.0 vs 1.1, P = .70) FWA scores were not significantly different.
Conclusions and Relevance
In this study, the use of procerus and corrugator myectomy techniques appeared to achieve a superior long-term reduction in glabellar wrinkles vs forehead rejuvenation techniques without muscle resection.
Level of Evidence
Starkman SJ, Sherris DA. Association of Corrugator Supercilii and Procerus Myectomy With Endoscopic Browlift Outcomes. JAMA Facial Plast Surg. Published online May 02, 201921(5):375–380. doi:10.1001/jamafacial.2018.2084
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