The paired corrugator supercilii muscles originate from the superomedial brow, traverse the galeal fat pad, and insert on the skin of the central brow. The corrugator muscles lie deep to the procerus and frontalis muscles. Contraction depresses the central brow, creating vertical and oblique glabellar rhytids (FIG 1).

The procerus muscle takes its origin in the lower nasal bone and inserts into the skin overlying the nasal root. Contraction depresses the central brow and creates a transverse line at the nasal bridge.

The procerus and corrugator muscles can be identified by asking the patient to frown.

It is important to distinguish between dynamic lines, which are evident only on animation, and static rhytids, which are uniformly present and are more challenging to correct. The Glogau classification of photoaging describes the severity of actinic changes based on the degree of skin wrinkling.

Injection of neurotoxins is most effective in relaxing the muscles to temporarily eliminate glabellar rhytids. Etched or deep lines may also be improved with resurfacing or injections of fillers.

Glabellar frown lines can be addressed through an upper eyelid blepharoplasty incision in patients with little or no medial brow ptosis and no excess skin above the nasal radix. In patients with significant lateral brow ptosis, the procedure can be paired with a lateral temporal brow lift.