How can I get rid of a forehead "dent" after Botox injections (post-mini-forehead lift with fat injections)? (Photos)

Question

Last year, I had a successful mini-forehead lift with fat injections. After 8 months I got Botox (2 sessions 3 months apart) for expression lines in forehead above the eyebrows. Last month, I developed a "dent" in the forehead's mid-section. My aesthetic nurse said the Botox may have caused muscle atrophy there. How can I get rid of the "dent"? Should I stop getting Botox, to prevent more "dents" that will damage the good results of the mini-forehead lift/fat injections I had? Thanks.

Matthew Richardson, MD · Answer

It is very unlikely that Botox would cause any depressions in the forehead. These types of changes are possibly related to altering the underlying muscle or soft tissue of the forehead during a brow lift. The most likely cause of these types of changes in a patient that has had fat transfer to the forehead would be irregular resorption of fat in the forehead. Be sure to discuss any post-operative concerns with the surgeon who performed the procedure as a starting point. Fillers could be used to fill in a soft tissue defect if desired.All the best,

Andrew P. Trussler, MD · Answer

Unlikely a forehead dent would be caused by Botox and if it is then it should get better. Botox does cause temporary muscle atrophy which will resolve. The most likely cause is galeal scoring or muscle scoring from the browlift or non-take of fat if fat was injected there. The correction could be corrected with Botox and if it occurred after 2 months after Botox then it is likely browlift related.

Jason Emer, MD · Answer

It is highly unlikely that this was caused by Botox. You may have had an irritation or possible infection from the injection site. Please, see an expert. Best, Dr. Emer

Jonathan Kulbersh, MD · Answer

This isn't typical after Botox. Botox results generally resolve in 3-4 months. Fillers may give improvement. I recommend getting a consultation with a cosmetic dermatologist. Hope this helps.

Bruce K. Smith, MD · Answer

Irregularities can be caused by any procedure with scar tissue under the skin. Slight indentations or irregularities like this can usually be successfully treated with release of the scar (subcision, often done with the tip of a needle) and placement of filler or additional fat. Please select a surgeon board certified by the American Board of Plastic Surgery, preferably a member of the ASAPS, (American Society of Aesthetic Plastic Surgeons).

Shaun Patel, MD · Answer

It is certainly not common to see this after Botox treatment. Actually, I have not seen a case of skin atrophy after Botox treatment. I recommend you followup with another aesthetic physician for an in person evaluation and to determine what could be done to correct this dent.

Prashant Murugkar, MD · Answer

hi this is most unfortunate that the dent has appeared after botox, the only way around it would be to wait for the effects of botox to wear of to see if it reverses or to use some filler injection to level out the dent hope this is of help, do keep me posted of your progress warm regards Dr Prashant Murugkar

Nicholas Gentry, MD · Answer

tough to say from just photos but it appears to be that Botox has caused atrophy (shrinking) of the muscles allowing the uneven texture of the forehead to be seen. An exam would be needed but options would include fat transfer or filler most likely

How can I get rid of a forehead "dent" after Botox injections (post-mini-forehead lift with fat injections)? (Photos)

Answers (8)

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