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Surgical Technique |

Radiofrequency Ablation of the Nerve to the Corrugator Muscle for Elimination of Glabellar Furrowing

David S. Utley, MD; Richard L. Goode, MD
Arch Facial Plast Surg. 1999;1(1):46-48. doi:10.1001/archfaci.1.1.46.
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Glabellar furrows are caused by hyperdynamic activity of the corrugator supercilii muscles. A minimally invasive, percutaneous technique for eliminating glabellar furrows is described. An insulated, bipolar needle is inserted vertically through the eyebrow skin to entrap the corrugator nerve plexus. To confirm proper positioning, a stimulating current is delivered to the needle during observation of corrugator supercilii muscle response. Radiofrequency energy is then delivered to the needle, thereby ablating the intervening nerve tissue. This technique is in the early stage of optimization and is being evaluated in an ongoing Stanford University Human Subjects protocol, Stanford, Calif. The preliminary results are reported herein.

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Figure 1.

Bipolar needle device. Each needle is exposed at the tip and insulated proximally. A thermocouple is embedded in the tip of each needle, providing temperature feedback for the power algorithm of the radiofrequency energy generator.

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Figure 2.

Patient undergoing localization and radiofrequency energy ablation of the corrugator motor nerve plexus with the revised technique using an inferior approach. The bipolar needle is inserted through the brow skin at the level of the orbital rim, 10 mm lateral to the supraorbital notch.

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Figure 3.

Patient is shown after being asked to frown before (left) and 7 weeks after (right) radiofrequency energy ablation of the corrugator motor nerve plexus.

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