A new minimally invasive procedure, glabella frown relaxation (GFX), is described to offer an alternative treatment to botulinum toxin A for the reduction of glabellar furrowing. A unique bipolar radiofrequency (RF) device has been developed and used to produce selective denervation of the corrugator muscle by a percutaneous, minimally invasive route that can be performed in an office-based setting. A description of the targeted nerves, procedure, and clinical results to date is given here.

The minimally invasive procedure uses a RF needle and generator specifically designed for peripheral motor nerves (GFX Generator, ACI Inc.). The use of this technology to ablate only the efferent pathway of the distal branch of the frontal facial nerve branch as it enters the corrugator muscle yields a very selective relaxation of the forehead depressor function. This selective efferent nerve ablation provides a nonpharmacologic relaxation of the corrugator muscle by creating a neuroablation of the motor nerve to the corrugator. The application of optimized RF energy has a long history of success in treating various conditions, including cardiology applications such as ablation of tachyarrythmias (Utley and Goode 1999; Hernandez-Zendejas and Guerrero-Santos 1994). Previous studies (Hernandez-Zendejas and Guerrero-Santos 1994; Ellis and Bakala 1998) have demonstrated efficacy of application of RF energy in the human forehead to produce acute and long-term reduction of glabellar furrowing. The GFX generator and handpiece have undergone both animal and human studies to refine the waveform of energy delivery and keep the lesion production process highly reproducible.