Q: Dr. Eppley, I want to get rid of my frown lines between my eyebrows. I know that Botox is most commonly used to treat them but I am looking for something more permanent. I have read that a browlift operation can be used to get rid of those scowling muscles. What I am now confused about is whether a coronal or an endoscopic browlift technique would be better.
A: The first thing to understand is that the idea of permanently getting rid of frown lines by surgery does not exist. Browlift methods can help reduce their action but can rarely permanently eliminate their effects. Their action can be reduced by partial muscle avulsion through either an open (coronal) or closed (endoscopic) browlift. There are indications for either type of browlift depending upon the anatomy of the eyebrow and forehead, the location and density of the hairline and the vertical length of the forehead skin. These features are what decides which browlift approach is best, not the action or depth of the frown lines. There are some that would say that an open browlift approach is more effective at getting more frown muscles out due to the open exposure. But those very skilled in endoscopic browlift techniques may be able to offer similar results. For now, however, Botox injections remain as the most effective method of obliterating frown lines even though its effects are not permanent. This effectiveness over that of surgery is one reason why Botox and its competitive analogues are so successful commercially.
Dr. Barry Eppley