Dr. Bunkis has been practicing plastic surgery for 30 years.

Q: Botox does wonders for the frown lines between my eyebrows but I’m not particularly fond of the shots. Also, Botox does not work very long on me. My dermatologist told me that I built up a resistance to the Botox but I have to get another set of shots every 3 months if I am to keep my lines away. Can you do plastic surgery on these lines and make them go away?

-J.L., Corona del Mar

A: I'd like to make a couple of comments. First of all, Botox is a very effective muscle paralyzer and works almost always by weakening the muscles into which it is injected. You are not unusual in seeing the results fade away after about three months. We have performed thousands of similar injections and find that the effects of Botox rarely last longer than what you have experienced. Botox injections are very useful for someone wishing to look their best for a special occasion, but many patients dislike repeated injections on a permanent basis. The same muscles that cause these frown lines, called the corrugators and procurus muscles, can be surgically removed with a minimally invasive procedure called an endoscopic brow lift. This approach is similar to what an orthopedic surgeon does when he looks into a knee or shoulder with an arthroscope, or a gynecologist does when looking at internal organs with a laproscope through an umbilical incision. The approach is minimally invasive, yet accomplishes the same result as the older forehead lift which entailed making a long cut across the entire scalp. In the endoscopic brow lift, a few half inch incisions are made behind the hair line, allowing the instruments to be inserted. The tissues are freed from the bone, the muscles sculpted, and the brows usually raised a few millimeters. The brows are fixed in their new position with a variety of devices. The incisions are rarely perceptible after healing has taken place. Healing from this minimally invasive procedure is quick and there are no tell tale signs of surgery. Occasionally, a brow lift will be performed as an isolated procedure, but more commonly it will be combined with a minimally invasive mid-face or thread lift, an eyelid procedure or a standard face lift. If you have any specific questions about cosmetic procedures, your best bet would be to see a qualified plastic surgeon to review your options. Pease feel free to contact our office at 949-888-9700 to set up an appointment with Dr. Bunkis; you may also check out our web site at www.ocps.com to see further examples of similar patients.
 

Pre & Post Brow Lift: 68 year old with frowning and minor neck laxity following prior facial surgery. This time tightened her neck a little and did and endoscopic brow procedure to remove the hyperactive muscles between her brows and along the central forehead, giving a permanent correction of the furrows between the brows and removing need for future Botox injections.

As Medical Director of Orange County Plastic Surgery, Juris Bunkis, M.D., F. A.C.S. brings 30 years of surgical expertise to our communities. Dr. Bunkis is a Harvard trained, Board Certified Plastic Surgeon and Member of numerous prestigious organizations including the American Society of Aesthetic Plastic Surgeons, The International Society of Aesthetic Plastic Surgery, the American Society of Plastic Surgeons and the California Society of Plastic Surgeons. Dr. Bunkis, a former faculty member at the University of California, San Francisco, has published more than 40 scientific publications, abstracts and book reviews, and 17 book chapters in plastic surgery text books. Dr. Bunkis will be regularly featured in this Cosmetic Surgery Q&A column. We invite you to call Dr. Bunkis at 949-888-9700, or email your questions to bunkis@ocps.com .