B. Guyuron et al., CORRUGATOR SUPERCILII MUSCLE RESECTION THROUGH BLEPHAROPLASTY INCISION, Plastic and reconstructive surgery, 95(4), 1995, pp. 691-696
Corrugator supercilii muscle resection through an upper blepharoplasty
incision, with or without concomitant blepharoplasty, is suitable for
patients who have significant corrugator hyperactivity and deep frown
lines without eyebrow or forehead ptosis. This procedure is also appr
opriate for patients who decline a forehead rhytidectomy. After infilt
ration of local anesthesia with intravenous sedation, skin and fat are
excised when a concurrent blepharoplasty is planned. The plane betwee
n the orbicularis oculi muscle and the orbital septum is dissected unt
il the corrugator supercilii muscle is exposed. This muscle is identif
ied immediately cephalad to the medial half of the superior orbital ri
m. The muscle is resected carefully to prevent injury to the supratroc
hlear nerve medially and the supraorbital nerve laterally. The resulta
nt depression is eliminated with fat removed during the blepharoplasty
, or fat or dermis from other sites should the aesthetic plan not incl
ude eyelid surgery. Eight patients, seven females and one male, underw
ent this procedure. The follow-up period ranged from 11 to 19 months,
with a mean of 14.5 months. Patients' ages ranged from 25 to 66 years,
with a mean of 51.3 years. A scale of 1 to 5, with 5 being excellent,
was used to rate postoperative appearance, producing a mean of 4.25.
The advantages of fewer skin incisions, less tissue mobilization, and
a direct approach to the origin of the problem make this procedure a v
aluable adjunct to the cosmetic surgery armamentarium.