Background: Glabellar frown lines are a common aesthetic concern, and minimally invasive techniques to treat frown lines have become popular. Objectives: The authors developed a technique to minimize frown lines by means of percutaneous myotomy with a small needle-knife and lipoinjection. Methods: Sixty-nine patients underwent treatment of the glabellar frown lines in a prospective study. Percutaneous myotomy of the corrugator supercilii and procerus was conducted with a small needle-knife, and autologous fat was transferred to the glabellar region. Two independent investigators assessed improvement of the glabellar frown lines by applying the Merz Facial Wrinkle Scale preoperatively and 6 months postoperatively. Improvement by >= 1 point was regarded as a response to treatment. Patients also conducted a self-assessment based on the Global Aesthetic Improvement Scale. Results: The mean follow-up period was 8 months. The evaluators determined that the glabellar frown lines of 62 patients (89.9%) responded to treatment. For 4 patients (5.8%), the frown lines were partially improved, and the frown lines did not improve for 3 patients (4.3%). In a self-assessment, 64 patients (92.8%) perceived improvement in their frown lines 6 months postoperatively. No serious complications were recorded. Conclusions: Treatment of glabellar frown lines by percutaneous myotomy with a small needle-knife and lipoinjection is reliable and minimally invasive.