Botox vs. Surgery for forehead wrinkles

Raffy Karamanoukian, MD answers: How do I get rid of forehead wrinkles?

People always say I look angry or worried because I have wrinkles on my forehead. Which wrinkle treatments will get rid of forehead lines?


Raffy Karamanoukian, MD
9 months ago

Forehead wrinkles are caused by overactive frontalis muscles underneath the skin of the forehead. These muscles are deactivated by a commercially available medicine: botox. 

Botox works by inhibiting the release of acetylcholine neurotransmitters across the synaptic junction.  Once blocked, the muscles are not able to tighten and this minimizes, temporarily, the wrinkles found on the forehead.

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A: Getting Rid of Forehead Wrinkles

Arnold W. Klein, MD
20 months ago

Those bothersome wrinkles in the forehead that we all get as we get a bit older come primarily from the repeated movement of the forehead due to expression; these are called dynamic wrinkles. It is impossible to prevent these, but we are able to get rid of them very nicely with a little Botox.

The main goal in doing this is to eliminate the deep wrinkles and lines, but not eliminate facial expression. There are too many people walking around who have overdone the Botox and look like the Stepford wives with frozen or flat expression.

It is very important to go to a well-qualified and well-trained cosmetic specialist for this treatment. There are serious adverse side effects if Botox treatment is not done by well-trained and specialist physicians, so select your doctor carefully.

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A: Softening the "angry" look

Harold J. Kaplan, MD
4 months ago

All good feedback from the panel members. Using Botox or Dysport is an excellent first option in relaxing the muscles that are contributing to this appearance. What you may be noticing may actually be a different muscle group rather than the forehead muscle. Generally, when people complain that they look angry, they have overactive muscles that are contributing to the frown lines aka:  "the elevens." These muscles are considered "depressors." This means that they pull down and in with time. This then may lead to an angry or tired appearance. By relaxing key muscle groups, the face will appear naturally refreshed and with a subtle lifting of the brow.

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A: Botox for forehead lines and angry look

Michael A. Persky, MD
19 months ago

By far, Botox is the best treatment to get rid of your worried/angry look.  It relaxes the muscles that cause dynamic forehead lines and wrinkles.

Have fun.

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A: Botox or Dysport first choices for forehead wrinkles

Lawrence A. Osman, MD
4 months ago

Botulinum toxins (Botox or Dysport) are definitely the best first choice for treating forehead lines.  When placed carefully, they can produce amazing results.

As you know, other options including a forehead lift exist. Treatment with Sculptra is another one to know about for treating horizontal forehead lines. It is certainly not commonly used, but it has been reported to work well. I would try Botox or Dysport first, but it is another treatment to know about if they do not provide satisfactory improvement.

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A: Dysport or Botox work great for most forehead wrinkles

David Hansen, MD
22 days ago

Dysport or Botox work great for most forehead wrinkles and last about 3-4 months at a cost of roughly $350. It only takes about 2 minutes to do.

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