Will horizontal wrinkles on the bridge of the nose improve with a forehead lift? Fixation points and pre-consultation checklist (before and after photos)

 

hello, Director Baek In-soo of Garnet Plastic Surgery no see.
I very frequently receive the question in the clinic, "I understand forehead wrinkles, but why do these horizontal wrinkles on the bridge of my nose remain the same?"
profusely Elephant wrinkles This is a story about the horizontal wrinkles on the upper bridge of the nose, called [name].

 

This wrinkle almost invariably comes up during consultations for a forehead lift. However, if you decide on surgery with the simplistic assumption that "pulling the forehead upward will naturally smooth it out," the results may deviate from your expectations.

 

Today, starting with the reason why horizontal wrinkles form on the bridge of the nose, and why in forehead lifts Fixed point I will summarize everything up to whether you need to consider it.

 

💡 Key points to know first
The horizontal wrinkles on the bridge of the nose Wrinkles etched into the skin itself It could be, Wrinkles formed by repeated muscle contractions It could be. Depending on which is the primary cause, what is released during the forehead lift and where and in what direction it is fixed will differ completely.

 

🔹 Why do horizontal wrinkles form on the bridge of the nose?

In many cases, the wrinkles are caused by muscles, not by sagging skin.

The horizontal wrinkles on the upper bridge of the nose are mainly procerus It is associated with repetitive contractions. In some cases, corrugator and frontalis The action of is also involved.

 

Especially those with drooping eyebrows try to open their eyes wide Overuse of the frontal muscle This happens, and if this habit persists for a long time, horizontal wrinkles on the forehead can also deepen. So, it is not just a problem of wrinkles on the bridge of the nose being isolated, A problem intertwined with eyebrow position and facial expression habits That is essentially the case.

 

📌 Before (top) and after (bottom) forehead lift. The horizontal wrinkles on the bridge of the nose and forehead, as well as the position of the eyebrows, have changed together. (Partial model photo with consent for publication)

 

🔹 Will wrinkles on the bridge of the nose smooth out just by pulling on the forehead?

'Pulling,' 'releasing,' and 'reducing muscle mass' are different issues.

Many people understand a forehead lift solely as a 'surgery to pull the skin upward.' However, to also improve horizontal wrinkles on the bridge of the nose, the following three procedures must be planned separately.

 

🔸 Reducing the action of the procerus corrugator
If the wrinkles are caused by muscles, there are limits to simply pulling the skin.

 

🔸 Sufficiently releasing the soft tissue around the radix (root of the nose).
If you do not release them, the organization will not move as much as they want.

 

🔸 Adjusting the position and angle of the inner part of the eyebrow
Even with the same 'lift,' the impression changes significantly depending on the direction.

 

In fact, in endoscopic forehead lifts Release and treatment of corrugator and procerus It is explained as an important factor in improving eyebrows and frown lines. Thus, multiple steps are encompassed under the single name of forehead lifting.

 

🔹 Why are fixation points important in forehead lifts?

It is a process of distributing tension in multiple directions rather than firmly fixing one spot.

When talking about fixed points, rather than "Where do you pull the hardest?" How do you distribute the tension to match the desired eyebrow shape? That is a more accurate question. The main areas checked are summarized as follows:

 

region	What to decide	Points to consider together
Central forehead · Midline	Elevation of the central forehead and redraping of the frontal skin	Bone fixation of the central forehead is also used in recent literature.
inner part of the eyebrow (medial brow)	Directly connected to the impression of the bridge of the nose and the area between the eyebrows	If you raise it too much, it might look like a surprised expression. Set the target location in advance.
eyebrow tail (lateral brow · temporal region)	The rise of the tail of the eyebrow and the eyebrow arch (curve)	You must consider the anatomical risks associated with the temporalis facial nerve branches.
release around the supraorbital rim	The actual range of movement for an organization	It is important to release while preserving supraorbital nerves and blood vessels.

 

To summarize, "How much you release" is just as important as "where you set the fixed point." If you apply strong fixation without sufficiently loosening the tissue, it may not move in the desired direction or may slide back down over time.

 

🔹 If you have wrinkles on the bridge of your nose, ask these four things during your consultation.

You can see the main outline of the surgery plan just by checking four questions.

① Is the main cause of the horizontal wrinkles on the bridge of my nose procerus?
The surgical strategy varies depending on whether it is a simple skin wrinkle or if muscle contraction is the main cause.

 

② How do I treat corrugator procerus?
In addition to muscle resection methods, disinsertion and release techniques are also used. One study found that reducing contraction through disinsertion is more effective than completely resecting the muscle. It can help lower the risk of damage to surrounding sensory nerves. He reported it.

 

③ Does it release enough right up to the bridge of the nose?
In endoscopic forehead lift, the release of the nasal radix and orbital rim is presented as an important technical step.

 

④ How far do you plan to raise the inner part of your eyebrows?
If you lift your medial brow excessively to improve wrinkles on the bridge of your nose, the shape of your eyebrows may actually become unnatural.

 

🔹 What are the fixing methods?

'Which direction and where it is fixed' is more important than the device name.

In endoscopic forehead lift Suture fixation , bone tunnel , screw fixation , Fixed using devices such as Endotine , other Periosteum and bone fixation Various methods are used.

 

The important thing is, The fact that no single method is confirmed to be absolutely superior to all patients Recent reviews regarding fixation have also reported various outcomes and complications from different methods.

 

So when you consult, rather than "What kind of fixation device do you use?" In what position and direction do I move my eyebrows, and where and with what vector do I fix them? It is much more useful to ask that.

 

🔹 Side effects you must hear about before surgery

It is a relatively safe surgery, but there is a difference between making a decision with knowledge and going through it without it.

Forehead lifts are considered a relatively safe surgery, but the following problems may occur.

 

🔸 Decreased sensation or numbness in the forehead and scalp
🔸 Temporary headache or tightness
🔸 Asymmetry between left and right eyebrows
🔸 Problems with raising eyebrows too high or not being able to raise them sufficiently
🔸 Changes in eyebrow shape
🔸 Hematoma · Bleeding · Infection
🔸 Incision site hair loss · scars
🔸 Rarely, motor dysfunction of the facial nerve
🔸 Persistent paresthesia due to supraorbital and supratrochlear nerve damage
🔸 The phenomenon of the eyebrows drooping again as the fixation comes undone
🔸 Contour irregularity of skin or soft tissue

 

These complications are Differences depending on the surgical method and the layer of dissection There are. Previous systematic reviews have also reported paresthesia, scarring, hair loss, asymmetry, and eyelid closure problems.

 

especially supraorbital nerve This is very important. Since the course can vary from person to person, it is difficult to approach this simply by thinking, "I just need to avoid the nerve at a fixed location." Recent anatomical reviews also indicate that variations in this nerve It has a significant influence on the selection of the dissection layer and surgical method. He explains.

 

📌 Before surgery (left) and 2 weeks after surgery (right). Changes in horizontal wrinkles on the bridge of the nose and forehead can be observed even in the early stages of recovery. (Partial model photo with consent for disclosure)

 

💡 7 Things You Must Check During Pre-Surgery Consultation

✔ Is the main cause of horizontal wrinkles on the bridge of the nose procerus?
✔ Whether to release or disinsert the corrugator/procerus
✔ How much the radix and orbital rim are released
✔ How much to raise the medial brow and lateral brow respectively
✔ Where to locate the central, medial, and lateral fixation points
✔ How the supraorbital and supratrochlear nerves and the branches of the temporal-facial nerve are protected
✔ What is the possibility of recurrence and the plan for revision surgery when the fixation comes undone?

 

 

🔹 Frequently Asked Questions (FAQ)

Q. How much do horizontal wrinkles on the bridge of the nose actually improve?

A. The results vary significantly depending on whether the wrinkles are fixed to the skin itself or caused by muscle contractions, such as those of the procerus. It is also necessary to determine whether simply pulling the forehead upward is sufficient or if the muscles between the eyebrows and the bridge of the nose must be released as well.

 

Q. How does the fixation position of a forehead lift affect wrinkles on the bridge of the nose?

A. The position of the medial brow and the direction of pulling are particularly important. If fixed too strongly upward, the inner part of the brow may be lifted excessively, making facial expressions look unnatural; conversely, if the medial brow is not moved enough, the improvement of wrinkles on the bridge of the nose may be limited.

 

Q. How do I treat procerus and corrugator?

A. If the nasal bridge wrinkle is muscular, this is the key point. Depending on the surgical method, it is decided whether to resect the muscle, release or disinsert a portion of it, or preserve it. During this process, the possibility of damage to the supratrochlear and supraorbital nerves must also be considered.

 

Q. Is there no possibility of wrinkles reappearing?

A. If facial muscle movement persists even after a forehead lift, some wrinkles may recur. Additionally, it is advisable to check in advance for the possibility of asymmetry, changes in eyebrow position, decreased sensation in the forehead and scalp, headaches or tightness, scarring, and, rarely, nerve damage.

 

🔹 Conclusion

🔹 Key Points
Horizontal wrinkles on the bridge of the nose can be caused by either skin or muscle issues. The cause must be identified first to determine what to do during a forehead lift.

 

🔹 Management points
Forehead lifting is not a 'pulling surgery' Release · Move · Fix It is a three-stage surgery. Please ask about the fixation points and the release range together.

 

🔹 Reasons why specialist consultation is necessary
There are many structures, like the supraorbital nerve, whose course varies from person to person, so rather than a fixed manual A plan tailored to my anatomical condition This is important. You must consider your eyebrow shape and facial expression habits together to get closer to a natural result.

 

When you gently lift your forehead with your hand in front of a mirror, see if the wrinkles on the bridge of your nose smooth out along with it, or if they remain the same—that single small observation serves as a good starting point for a consultation. Please feel free to ask any questions you may have at any time ✨

 

Garnet Plastic Surgery Clinic
Director Baek In-soo

- Graduated from Korea University College of Medicine
- Graduated from Korea University Graduate School (Major in Plastic Surgery)
- Plastic surgeon at the National Medical Center
- (Former) Chief Director of Jewelry Plastic Surgery Clinic
- Regular member of the Korean Society of Plastic and Reconstructive Surgeons
- Regular member of the Korean Society of Aesthetic Plastic Surgery
- Regular member of the Korean Craniofacial Society
- Regular member of the Facial Contouring Research Group of the Korean Society of Plastic and Reconstructive Surgeons
- Regular member of the Oculoplastic Surgery Research Group of the Korean Society of Plastic and Reconstructive Surgeons
- Regular member of the Rhinoplasty Research Group of the Korean Society of Plastic and Reconstructive Surgeons