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Forehead Wrinkles?

Hi I have a lady who insisted on having treatment solely into her frontalis muscle as she wants her forehead lines treated and has been having this done for the last few years. I injected the standard 10 units into the frontalis and now 2 weeks on she says she has some response but not as much as usual. She is due her touch up appointment this weekend but i'm unsure exactly where I should retreat as i'm worried about brow droop if I inject any more without the glabellar area being treated also

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12 Doctor Answers | Asked by glampy in Kansas

Doctor Answers (12)
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Laxity of forehead

When I determine if there will be droopiness, I put my fingers on the forehead and push the skin caudad (toward the mouth) and see how much laxity there is of the skin. In some people, the frontalis muscle and eyebrows don't go down too much with this maneuver, so it is safe to inject more Botox. Stay between the pupils when you inject until you go up much higher on the forehead where you can drift above the lateral eyebrows and you can be safe. Do not inject too close to the eyebrows when... more

Undertreated Forehead

I would not say that 10 units to treat the frontalis muscle is standard. It depends on the size of the forehead Acitivity of the mimetic musculature in the region Maintenance of regular injections Brow droop is only encountered when Botox is placed into the incorrect area of the frontalis (too low, too lateral, too much) and should not be an issue for an experienced injector. She would be best referred to a board certified specialist to meet... more

Frontalis Injection Without Brow Ptosis

Frontalis injection with Botox will not cause brow ptosis if the Botox is injected well above the brow.

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Botox for forehead lines

Good for you for knowing your limitations. The amount of Botox required depends on the patient's muscle movement and response to Botox, and everyone will be different. If you are uncertain how to treat, suggest that the lady see a specialist.

True experience with facial surgical anatomy and musculature key for Botox/Dysport.

Glampy, As the other physicians have said here, it is unclear from your posting what your credentials or experience are with Botox injections. It's good that you are concerned about further frontalis/forehead injection without "support" injections at and below the brow line. If you aren't confident of your plan and are looking on the internet for physicians' input, just to be safe in this case, you may want to be referring your patient to a board-certified physician injector in one of... more

Botox and forehead

Maybe it's time to try a different neuromodulator - and as it's been reported, repeated smaller doses of Botox aren't always indicated.

Sam Naficy, MD

84 reviews

Seattle Facial Plastic Surgeon

www.seattleface.com

Botox for forehead wrinkles

I generally inject from 10-18 units into the frontalis muscle, based on the age of the patient, how much compensation they make in using the muscle, the strength of the muscle, and their expected outcomes. I treat most people with 12 units, and a few (usually men) with 18 units. Aim for the top one-third of the frontalis muscle to be safe.

Benjamin Barankin, MD

10 reviews

Toronto Dermatologic Surgeon

Don't use too much

I have a number of transverse forehead lines only patients. How much Botox depends on the muscle strength. I have used up to 18 units, but usually more like 12. Placement is important. As an aside I tried injecting way up high in my own frontalis, to get compensatory increased tone of the uninjected frontalis below, a Botox brow lift. I got maybe a millimeter at most, not terribly effective.

Brow droop

If the person is compensating versus animating, then paralyzing the entire frontalis will give you drooping. 10 units is not the standard as far as I know. Experience and individual dosing still is priority. Do not know your specific qualifications to inject, but as suggested...maybe the patient should go elsewhere

Michael Hueneke, MD

6 reviews

Nashville Plastic Surgeon

Treatment for forehead lines

I usually start with 10 units of Botox in the forehead. I use a slightly higher Botox dilution, which gives slightly more diffusion and, in my opinion, greater clinical effect for a given number of units. For a typical female patient, it's best to start with 10 units max to avoid the risk of eyebrow ptosis. You can always add more but you can't take it out if you put too much in. I agree that it's usually better to treat the glabella at the same time to relax the brow... more

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