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How Many Botox Units for Horizontal Forehead Lines?

I have about four forehead wrinkles that are getting deeper every day.  I call it my "washboard" forehead. How many units of Botox would I need to relax these forehead lines?

Doctor Answers (22)

There is no hard and fast rule.


Dear Cabbie02

I am not a big fan of injecting BOTOX into the forehead. The muscle up there, the frontalis muscle is the only elevator of the eyebrows. This means that any BOTOX injected into the frontalis muscle will drop the eyebrow position.

Yes one can certainly create a glass smooth forehead (Think Marcia Cross) but the price is a fall in the eyebrow position. The aesthetic price is very high because one gets this frozen forehead and a drop in the eyebrows that screams: MY FOREHEAD IS FROZEN BY BOTOX.

However, is there an alternative? The answer is absolutely: Microdroplet BOTOX. This is my patent pending method where tiny microinjections of BOTOX are place between the skin and the muscles of facial expression that insert into the skin along the eyebrow, root of the nose and the crows feet area.

This provides a degree of control over the placement of BOTOX that has not previously existed. The muscles responsible for pulling the eyebrow down and furrowing the eyebrow and glabella can be precisely targeted.

With the eyebrow depressing muscle treated in this fashion, the tug of war between the eyebrow lifting muscle and the eyebrow depressing muscles shifts to favor the brow elevator, the frontalis. This means that the frontalis muscle does not need to work so hard.

The eyebrow comes up and at the same time the lines in the forehead diminish without a bit of forehead freeze. This is one of the most popular BOTOX treatments in Los Angeles- the actors love it because they retain facial expression while at the same time having a very natural improvement in their appearance.

Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 15 reviews

Botox to the horizontal forehead lines

The amount of Botox injected in the  forehead lines will depend upon whether or not you want to completely" freeze" the frontalis muscle or just weaken it. The amount injected also depends upon how strong the muscle is, and how much deep wrinkles are present. Most patients require 20-25 units injected in the frontalis muscle to soften the lines.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Botox or Dysport for horizontal forehead lines: Catch 22.


When a patient comes to me with "washboard forehead" as you call yours, my first role is to lower expectations of what Botox or Dysport may be able to do for him or her. Unfortunately, the forehead can be a Catch 22 with Botox. The people with the deepest forehead lines use their frontalis forehead muscle the most to keep the brows up while talking and often to help them see. Trying too hard to smooth all of the lines out can weaken the muscle so much that you might end up with a flat forehead and drooping brows. This can be a, luckily temporary, disaster for the wrong person. 

I always recommend trying first to support the brows from underneath with a Botox or Dysport "brow lift", which can have a secondary effect of allowing the frontalis to relax, creating fewer wrinkles there naturally, while not causing any downward pressure on the eyebrows. After this kicks in for a few weeks, a lower number of strategically placed units can be lightly scattered in the forehead to soften without weighing down. 

Please see only a very experienced physician injector if your forehead has many deep wrinkles so you don't end up with a 3 to 6 month problem.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
5.0 out of 5 stars 39 reviews

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No Need to Over-treat!


“Washboard” forehead, ay? J The strength of the frontalis muscle varies tremendously from one patient to the next. While this muscle is a relatively thin one, it can create multiple ripples on the overlying skin surface.  Some of my patients just need about 8-10 units here (also depends upon the width of your forehead), while some of my wider-faced men need up to 24u (!). The last thing we want to is to overtreat this area leading to a heavy, Cromagnon looking forehead. I’d rather go a bit lighter, then touch up at no charge if necessary a week later.

Bobby Buka, MD
New York Dermatologist
5.0 out of 5 stars 7 reviews

How Many Botox Units for Horizontal Forehead Lines?


As I am not examined you, I can write generally you need 25 Units for Horizontal Forehead wrinkles .

Jhonny Salomon, MD
Miami Plastic Surgeon
4.5 out of 5 stars 36 reviews

Botox is a wonderful choice for forehead wrinkles...


especially if they are relatively superficial and present when you look up but not while you're sitting still without facial expression...of course the amount depends on the severity of the wrinkles and the size of your forehead...those with a high forehead obviously need more...generally somewhere in the range of 5-6 units to much more...and don't hesitate to go for a low dose to start...forehead muscles not too strong...not like the muscles between your eyes that will usually need more...a great way to make you look younger and more relaxed...

Ken Landow, MD
Las Vegas Dermatologist
5.0 out of 5 stars 7 reviews

Judicious use of Botox on the forehead


Botox can be used to lessen the transverse creases of the forehead but it will not iron them out completely.  If you plaster the forehead with Botox then the eyebrows will drop.  Not a desired look.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 8 reviews

Botox Units for Horizontal Forehead Lines


This is an issue that really varies among different patients. The results of your BOTOX® injection depend on a lot of variables, including your existing skin tone, the strength of your forehead muscles, the depth of your wrinkles and how well your body responds to the treatment. What I would recommend is consulting with an experienced surgeon who’s very familiar with the effects of BOTOX® to get the best results. You may also find even better results if you try combining the effects of BOTOX® along with injectable fillers to restore some of that lost volume that may also be contributing the deeper forehead wrinkles.

Joseph J. Castellano, MD
Tampa General Surgeon
4.5 out of 5 stars 7 reviews

Botox is ideal for forehead wrinkles

I love injecting Botox into the forehead! It has such wonderful and beautiful results. Proper placement and skill is needed in this area to prevent your eyes from appearing droopy.  Please consult a board certified dermatologist who has many years of experience in injecting Botox.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 27 reviews

Botox Units for Horizontal Forehead Lines


There isn’t a specific amount I can suggest because the needs of every patient are different. The units of BOTOX® needed will vary depending on how deep your forehead lines are, and how many wrinkles need to be addressed. Administering too much BOTOX® will run the risk of making the eyebrows look droopy. If the existing lines are already pretty deep, you may want to consider a dermal filler instead.

Michael W. Niccole, MD
Orange County Plastic Surgeon
3.5 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.