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Botox will work beautifully to smooth out the wrinkles betweenyour eyebrows, the area known as the glabella. My patients refer to them as the"11 lines" because they look like the number 11. Botox willprimarily correct the lines caused when you contract your muscles (dynamicwrinkles). If the lines are present at rest, you may require a combination ofbotox and dermal fillers to achieve the best result. After repeated treatments,you will require less botox to achieve optimum results. Consult with a boardcertified plastic surgeon to determine the best treatment option for you.
To treat the glabella there are multiple injections that occur between the brows and just above it. For the best results I encourage you to visit with an expert injector for an evaluation. She/He can demonstrate where the injections are made.
Hi Angie,I have found a nice diagram which you should click on below in the "Web Reference" box. The units will vary, but the locations are well illustrated. Botox injections should only be performed by trained professionals, do not try this at home! Choose your Botox physician most carefully for best results. Good luck and be well.Dr. P
While there is a basic overall pattern for injections in this area, no one person is the same and so no one person is injected in the same manner. That being said, best to actually see an experienced injector in person and have them treat you as they see fit to help you achieve the most optimal results. I hope that helps and wish you the very best.Warmest regards,-Gregory A Buford MD FACS PCEOBoard Certified Plastic Surgeon and AuthorNationally recognized Allergan Certified MASTER Facial Injectables Trainer
The amount of Botox required and the placement of the injections can be differ with each patient. Muscle movement and the strength of the muscle(s) are also considered. Next step for you is to consult with a board certified dermatologist or plastic surgeon to discuss your options and goals. Hope this helps.
The amount of Botox required and the placement of the injections can be different for each individual. Muscle movement and the strength of the muscles must be taken into consideration. Please have Botox treatment with an experienced physician injector such as a cosmetic dermatologist or plastic surgeon.
Thank you for your question angie1167. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.The appearance of frown lines is variable from person to person. Usually they are in a vertical orientation but sometimes they can be oblique and sometimes a horizontal line is seen across the upper portion of the nasal bridge. The most common variation is to have two parallel lines, hence the common term "11's" to describe them. But some people have one, three, or more lines. Some people also will see a bulge in the area when contracting the muscle. This bulge is smoothened out after a Botox treatment.The pivotal studies used 20 units of Botox in the glabella area between the brow to address the frown lines. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary. According to the on label guidelines there are five injection points between the eyebrow in a V-shaped pattern. The exact placement of the product varies from patient to patient. What I look for is the muscle and place the product in the muscle. Everyone has slightly different muscles and for some people it will be higher while for others it will be lower. Some people require more in the middle portion while others require more in the outer portions. Typically the product placed centrally is injected deeper into the skin while the outer injections are closer to the surface. The video shown here demonstrates such a treatment. If I had a patient with the concern described here I would recommend consulting with an experienced provider.Botox is a prescription strength medication that is injected into the skin or other areas. Therefore, it is important that the treatment is performed by a trained medical professional. This can be a physician, physician’s assistant, nurse practitioner, or nurse. Laws vary from jurisdiction to jurisdiction on who is allowed to provide the treatment. In California, for example, any of these aforementioned medical professional is permitted to provide a treatment. With the recent explosion of cosmetic medicine, there are more and more people offering such services. This includes core physicians such as plastic surgeons and dermatologists as well as other physicians who are trained in cosmetic treatments such as general physicians, gynecologists, or other specialists. It is important to understand that just because a doctor is a plastic surgeon or dermatologist does not necessarily make them an expert on Botox. General doctors who routinely perform Botox treatments multiple times per day likely have more experience and expertise than a plastic surgeon who spends most of his time performing surgeries and performs perhaps only a single Botox treatment per month. Similarly, there are many outstanding nurse injectors who spend their entire days performing cosmetic treatments, as they are often delegated to nurses. Their experience can at times be great than that of many doctors. This understandably makes it difficult to find a good provider. I recommend looking for experience (specifically in Botox and other minimally invasive cosmetic treatments such as fillers and lasers), before and after photographs, and testimonials. Looking for an office who offers the most competitive price is often a recipe for disaster. We have had many patients come to our office to correct various issues they have had when they selected an injector based on price alone.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile. After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities. Please consult with a doctor for specific recommendations. Good luck!
The shortest answer to your question is to look at the most medial portion of your eyebrow. Just above this approximately 1cm is the insertion of the corrugator muscle and is most appropriately injected to diminish its action in this location. With that being said it is common to perform 5 injections in a V shape across this area in a targeted fashion to access the corrugator and procerus muscles to diminish glabellar lines. Technique varies but this is the closest answer to what I believe you are specifically asking. Hope that helps!!
Typically, when the glabella is treated using Botox or Dysport, it is done so with a 5 point injection pattern. One injection into the procerus and 2 injections into each of two corrugaters. However, this is probably not useful to you as a patient. The best thing to do is find an injector you trust and let them do what they do best.