Why Do I Have an Indentation in Forehead After Botox?

I see this question was asked, but without any real answer. I, too, have an indentation occurring diagonally right above my left eyebrow all the way to the hairline. it looks worse than the original wrinkles did. also, it is in a place where I physically cannot make a wrinkle on my own (even before the botox). i cannot find one other photo pre-botox where I have this wrinkle so I can guarantee its from botox. will getting more botox help or should i just wait it off? it's been two weeks.

Doctor Answers (17)

BOTOX itself will not cause an indentation

+2

BOTOX itself will not cause an indentation. Botox is a muscle relaxer. However, if certain muscles relax and other muscles are not injected, those active muscles may be working harder and become more pronounced looking. You may have what appears to be a hole but is a depression area between a weakened muscle and a more active muscle. It will go away as the BOTOX wears off. You may also treat it by adding BOTOX to the muscle that is over worked. Just keep in mind that any kind of contra-irregularity in the forehead in regard to BOTOX is temporary and is a result of the way the muscles are working.


New York Oculoplastic Surgeon
5.0 out of 5 stars 19 reviews

New diagonal forehead indentation after Botox: what to do?

+2

This is why Botox is an art and not a cookie cutter. Sometimes Botox treatments weaken some muscles and reveal the unsual muscle patterns underlying the area that might be unexpected. It's always a better idea to start with new treatments conservatively and then increase here and there to avoid unwanted outcomes. Once you have an established successful pattern of Botox treatments with your doctor, then you know what works for you.

This is fixable by seeing a careful board-certified dermatologist or plastic surgeon who understands the underlying complex facial anatomy for an additional few units of Botox this time around, and different placement next time.

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

Botox indentation

+2

This is a rare response to botox or dysport. The frontalis muscle is the main muscle in the area but there are many muscles . There are two potential solutions: one go back to your doctor to inject a little more to deactivate the muscle or to wait until it wears off. Most patients would prefer immediate treatment.

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

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Botulinum toxin (Dysport and Botox) and unusual forehead crease

+1

There is an area of fixation of the tissues around the deep bransch of the supraorbital nerve where patients often develop a crease as they age. The botox may be "unveiling" the early tendency for this.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
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Indentation After Botox?

+1

Hi lajolla.  If the indentation was a result of the Botox injection, it should be fairly simple to correct it.  It's possible that the outer forehead muscles were not treated well enough and are causing this indentation because the rest of the forehead is relaxed and that area is not.

Best bet is to return to your injector and take a look at your before and after pictures.  This always helps.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Forehead Line after Botox

+1

Thanks for the picture! Looks like the line has been created between the interface of treated and non-treated frontalis muscle....easier to differentiate in person. Return to your physician injector as he/she may need to address with additional application of Botox to the area.

Good luck and keep us posted!

Dr. C

johnconnorsmd.com

John Philip Connors III, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 14 reviews

Indentation in forehead

+1

Addressing your concern with your injecting physician,should be the first thing you do. It looks as if a small amout of neurotoxin in the active muscles that are creating the line would help soften it.

Purvisha Patel, MD
Germantown Dermatologist
5.0 out of 5 stars 3 reviews

Indentation after Botox

+1

Without examining you in person, I would guess that that line is due to some residual frontalis muscle activity. If so, this can be treated easily with a small amount of Botox placed in this area. I would go back to your treating physician to discuss this.

Ryan Greene, MD, PhD
Fort Lauderdale Facial Plastic Surgeon
5.0 out of 5 stars 42 reviews

Why Do I Have an Indentation in Forehead After Botox?

+1

There are many muscles in the forehead that affect its movement.  Paralyzing some muscles may bring out action in other non-paralyzed muscles.  It is possible further Botox will help paralyze these muscles as well and solve the problem.  In the worst case scenario, you can wait until the Botox wears off and things should come back to normal.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon
4.5 out of 5 stars 13 reviews

Botox in the forehead

+1

This line represents the lateral portion of the frontalis muscle (muscle of the forehead that helps lift the brow). if the main body of the muscle is injected with muscle, it will not lift up but the lateral portion may still contract and create that line. You can have the problem fixed by have a small amount of Botox injected on that line but the risk is a droopy brow if too much Botox is injected. 

Henri P. Gaboriau, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 6 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.