In some people the forehead and eyebrows relax and droop even before this occurs in the eyelids or face. The problem may be due to genetic factors, diminished elasticity from sun damage, or excessive movement of the forehead muscles. These muscles are used frequently in facial expressions such as squinting, showing surprise, frowning, laughing, concentrating, or talking. As the muscles beneath the forehead move, the skin and tissues repeatedly fold, wrinkle, and stretch. As a result, the eyebrows fall into a lower position, especially on the sides. As your eyebrows droop, skin is pushed onto your upper eyelids giving them the appearance of having excess skin and further adding to a tired look.
Dr. Romano has in-depth expertise in glabellar muscle removal and can perform the surgery by removing the muscle through a brow lift incision or, more commonly, through the upper eyelid incision used for an eye lift.
This surgery has become exceedingly popular as the use of Botox has increased. In some ways it can be considered the permanent solution to Botox. Patients routinely present me with the complaints of hearing friends say, “You look angry” or “Why are you mad?” when, in fact, they are not. It is very understandable that patients notice this facial feature and are even more aware of the wide usage of Botox, and want something done. I can help you with this issue. There are other features that draw attention to the glabellar region, such as the presence of one or two deep lines between the eyebrows, the eyebrows being pulled down toward the nose, the angry look, and the frowning look. The anatomy of the area mostly centers on the glabellar muscles and their function. They attach from the edge of the eyebrows to the bone on the sides of the forehead. As they contract the wrinkles and furrows are created. This is often an isolated event, but it may be associated with other eyelid and forehead functions so that there are other different anatomic features in this case that might need to be addressed prior to your surgery. The surgery is safe and predictable. There is very little bruising or swelling, and all of the stitches are dissolvable. You can return to work in as little as one to two days and to some physical exercise within the first week.
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