The corrugator and procerus muscles act on the brow position at all times. They are considered “depressors” of brow position, because they pull brow position down towards the nose and mouth. On the other hand, the frontalis muscle and orbicularis oculi muscles are considered “elevators”, because they pull brow position up, towards the scalp and hairline.
Our Philosophy of Care with Neuromodulators
Neuromodulators (Botox®, Xeomin®, and Dysport®) are cornerstones of our facial aesthetic practice at Ocean Drive. We firmly believe that all three have their uses for prejuvenation, beautification, and rejuvenation. While all three have their advantages and disadvantages, all three can produce the chemical brow lift effect, which we believe is one of the critical goals of all neuromodulator treatments. Most physicians and injectors view Botox, Xeomin, and Dysport as primarily wrinkle removers, and that is okay. We believe, however, that classifying these medications as wrinkle removers is limiting and misleading.
In reality, these interventions are intended to brighten your eyes and globally improve your countenance first, and then remove the wrinkles. Consider for a moment that the “11’s” on your face are caused by the corrugator muscles, and that when you treat the “11’s” you are also serving to elevate the medial brow. We always counsel patients to treat the lateral brow and crow’s feet when receiving neuromodulators, because that completes the brow elevation/eye brightening component of the injections. We elevate your brow first, brighten your face globally, and then use the remainder of the treatment to remove any remaining wrinkles.
This approach to using neuromodulators minimizes chances of overtreating patients, and it minimizes that “Botox look” that commonly occurs when patients receive inaccurate injection patterns, or too strong of an injected dose. At your treatment, we will determine the minimum dose necessary to create a brow lifting effect (usually 20-30 units of Botox or Xeomin, 60-90 units of Dysport, but dosing may vary). For many patients, that is all they will require as the brow lift approach will also address your glabellar lines (aka the 11’s), and your crow’s feet. For patients who want further wrinkle reduction to the brow and forehead, they will typically receive 50% of the brow lift dose to their forehead (usually 15-20 units, but dosing can vary). This approach consistently limits the amount of neuromodulator necessary to achieve the best possible result, which in turn represents a significant cost savings to our patients without having to sacrifice their result.