Call Us : 415.898.4161

Alternative to Botox…Corrugator Muscle Excision With Brow Lift

February 28th, 2013 Miguel A. Delgado Jr, MD


Before and After Brow lift, eye lift and corrugator release



Botox has been used for treatment of the glabellar frown lines since 1992. The glabellar frown lines are the moderate to severe frown lines between the eyebrows. Marin County patients have asked if there is a more permanent treatment available other than repeated Botox treatments every 3 to 4 months or for some 6 to 8 months. The answer is yes, the corrugator muscle excision. The corrugator muscle excision can be done in conjunction with a brow lift or upper eyelid lift.

The corrugator muscles are used frequently when we laugh, frown, squint, concentrate, and show surprise or anger, causing the skin and tissue to wrinkle and stretch. Botox temporally weakens or relaxes the muscle allowing the frown lines to disappear. If the corrugator muscle is surgically removed, Botox injections will no longer be needed.

San Francisco Bay Area patients may be interested in discussing the corrugator muscle excision with Dr. Delgado at the time of their consultation for any cosmetic facial procedures.

Methods of Fixation for the Endoscopic Brow Lift

August 16th, 2012 Miguel A. Delgado Jr, MD

Before and After Brow Lift

The endoscopic brow lift (forehead lift) for the cosmetic surgery patient is considered to be a minimally invasive procedure with usually three to five small incisions within the hairline leaving almost no visible scar after healing.

Fixation is the term for anchoring the brow in place during a brow lift. With the advance of technology, new and improved methods have evolved. For many years, the popular method of fixation was with permanent hardware “screws”. Another method is with removal of the screws once the brow has become anchored in place and healed. A later technique is bone tunnel fixation where screws are not used at all. Recently, another popular method is the bioabsorbable screw fixation which provides precise fixation without permanent screws or the need for removal. The determination of method of choice for a surgeon would be experience and personal preference. San Francisco Bay Area women find the brow lift a fantastic procedure for rejuvenation of the upper third of the face.

What Procedures are Typically Included in a Facelift?

April 4th, 2012 Miguel A. Delgado Jr, MD

Many San Francisco Bay Area patients are confused as to what procedures are included in facelift surgery, also known as a rhytidectomy. A “facelift” can mean different things to patients and surgeons alike. You want to be sure that you and your surgeon are in agreement as to what is included.

For the practice of Miguel A. Delgado, M.D. a detailed quote is given to the patient at the time of consultation to avoid any misunderstandings. For Dr. Delgado, a “lower facelift” includes the lower face, jowl and neck. A “facelift” can and is different for almost everyone depending on their needs. A full face lift can include a brow lift, upper and lower eyelids or just upper or just lower eyelids.

Many patients opt to have additional procedures done as they plan to have surgery only once. Some of these procedures could include:

• Chin implant

• Lip augmentation

Fat injections

And many patients want to include other procedures because they will be asleep, such as:

• Medium to deep skin peel

• Botox injections

• Fillers such as Restylane, Sculptra or Juvederm

Beware of advertised procedures that claim they can be done in an hour, they are short cuts that will not give lasting or satisfactory results.

Depending on age and genetics a limited facelift, such as a “short scar facelift” may provide adequate rejuvenation and still have facial harmony for those who choose to have less surgery. This is where the patient and the surgeon need to discuss expectations, and the patient needs to understand the surgeon’s recommendations. Dr. Delgado finds that computer imaging that he offers at the consultation helps clarify goals for the patient.

“Brow-pexy” an Alternate Brow Lift

May 17th, 2011 Miguel A. Delgado Jr, MD

San Francisco patients feel the brow lift is one of the most exciting procedures done for rejuvenation of the face. There are several different approaches to doing a brow lift, but for those who would be a candidate, the “brow-pexy” is one of the newest, with great advantages in that it is a much less invasive procedure.  This procedure does not lift the entire brow but the lateral aspect or “tail” of the brow.  

The Brow-pexy is most often done in conjunction with upper eyelid surgery as the access incision line is the same, which is in the natural crease of the eyelid. “Pexy” means to secure or fix. Through the incision, there is removal of excess muscle and fat and a bit of skin, using hidden stitches; the eyebrow is “fixed” at a higher, more desirable position. This prevents the brow from dropping below the superior bony ridge and creates a sculptured upper eyelid. This procedure has more direct control of the final shape and position of the lateral eyebrow. This has proved to be an excellent procedure for Bay Area men who are concerned about visible scars on their scalp.

Many Marin patients opt for an additional procedure that can easily be done at the same time. This would be the “corrugator muscle excision”. The corrugator muscle is the muscle that allows the eyebrows to squeeze together forming worry or frown lines. By removing a part of this muscle the patient will not be able to create the line between the brows, having a similar effect as Botox injections except the results are permanent.