Chemical Browlift

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Abstract
THE USE of botulinum toxin type A (Botox, Allergan, Irvine, Calif) for treating hyperfunctional lines and wrinkles has been well-described, and the toxin is rapidly establishing its place in the practice of cosmetic surgery.1-6 By blocking the release of acetylcholine at the neuromuscular junction, botulinum toxin type A temporarily paralyzes the affected muscles and as a result, the lines in the skin formed by the continuous activity of these muscles tend to smooth out in time.1,2,7,8 During use for treating glabellar frown lines, it became apparent that many patients were experiencing elevation of their medial brows. To explain this phenomenon, it was proposed that the botulinum treatment had selectively paralyzed the muscles that depress the brows and resulted in unopposed action of the frontalis fibers that raise them. The overall effect of this shift in the equilibrium led to brow elevation. With some anecdotal evidence and a working hypothesis in hand, we undertook to determine if botulinum toxin type A is capable of creating a medial browlift.