Your Questions

Q: Dr. Eppley, Is it possible to do forehead lift to rid of  horizontal wrinkle lines and raise the forehead but not move eyebrow position? Because I have many forehead wrinkles. I have tried Botox but I want a permanent result. I don’t want any movement position in eyebrows. How is it done?

A: What you are asking can not be done exactly the way you want it. You can not permanently paralyze the entire forehead even with extensive muscle stripping. And if you remove all the muscle between the eyebrows to try and achieve it you will need up with a dent or depression between the eyebrows. You definitely can weaken it considerably by muscle resection (glabellar area) but it should be combined with the placement of a dermal-fat graft in the resected area so that a depression  is not created and it will inhibit any muscular reattachments as well.

In reality a forehead lift and a browllift are one and the same. A forehead lift can not be done without some browlifting effect. That effect can be made minimal but no change can be done in the forehead without some potential change occurring in the brow area riught below it.

Dr. Barry Eppley

Indianapolis, Indiana

Q: I am 36 years old and have had fairly deep forehead lines for quite a few years now, which appear to be getting worse. Is there something other than plastic surgery or Botox that I can do to help my problem?  I am desperate!

A: The simple answer is…no. But let me explain why. Wrinkles on the face form perpendicular to  the direction that the underlying muscles move with facial expression. The well known horizontal lines on the forehead are a result of the large frontalis forehead muscle that attaches to our eyebrows and goes across our forehead the whole way to the back of our head. As you move your forehead with expression, the muscle lifts the eyebrows and creates the horizontal lines. The only way to stop them from forming, therefore, is to stop moving your forehead. Notice the difference in the depth of the forehead wrinkles when your forehead is still and not moving versus when you are lifting your eyebrows. (that difference is important for treatment considerations below)

There are only two non-Botox and non-plastic surgery options that can reduce your forehead wrinkles. A state of permanent facial paralysis is one option, otherwise known as death. Very effective but not appealing. The other option is to retrain your facial expressions so you don’t move your forehead anymore. Theoretically possible but if you are successful you will be the first human to have successfully done so.

I tell you this so in your desparate state so you don’t chase worthless treatment options and throw away money…or actually transfer your assets to the benefit of someone else. So do not chase the illusion of innumerable skin lotions, potions and facial exercises that promises a miracle wrinkle cure.

That leaves you with exactly what you want to avoid, Botox and forehead surgery, Unappealing but actually the only things that will work. Back to the depth of your forehead wrinkles when they are still versus moving. If the depth of the forehead wrinkles is acceptable when your forehead is still, then Botox would be the preferred treatment. If the depth of the forehead wrinkles at rest is still not acceptable, then a forehead lift with muscle removal would be the better treatment.

Dr. Barry Eppley

Indianapolis Indiana