Q: Dr. Eppley, I’ve been struggling with the depression in my forehead, there’s irregularity like a W where the bones right above my eyebrows seem to be swollen to the outside with a depression in the middle.. It makes me look as if I’m frowning all the time. I’m looking for a permanent solution to my problem. Is there one? Is there such a thing as a glabellar implant? If so will you please advise me of the price and if insurance would cover even part of the treatment? I have attached 2 pictures, please let me know if they aren’t clear enough.Thank you so much doctor.
A: Based on the pictures you have shown and by your description, this is most consistent with a glabellar bony depression between the medial (inner) ends of the brow bones. This is a much more common lower forehead shape in men than in women. I will assume that you have tried Botox injections so we know that it is not problem that is solved by muscle relaxation.
Assuming that the shape of the underlying bone is the main culprit, your options are two fold. One approach is with fat injections to thicken up the vertical soft tissue indentation. The potential success of this approach can be determined before surgery with simple saline injections. While this is the simplest method of tissue augmentation its ultimate success depends on how much fat takes and persists…which can be unpredictable.
The second approach is the placement of a glabellar implant. Inserted endoscopically through small scalp incisions. Such an implant fills in the depression or hollow between the bony eyebrows. Its volume retention is assured.
Dr. Barry Eppley