Botox: Forehead or Glabellar?

Your photograph shows no lines in the glabella or forehead. Just some smile related crows feet.  If you want to maintain the effect of Botox which apparently has made you happy by limiting or erasing the lines on the forehead and crows' feet, then you should stay with that.  The glabella and forehead are two dynamically different areas.  It actually is VERY unusual that I only treat the forehead without treating the glabella because there can be a droop of the forehead if the glabella is not treated to help lift.  Furthermore, the number of units to treat a forehead usually is smaller than the glabellar treatment, so you would not necessarily save money by changing the treatment.

To answer you question, you should get your forehead injected, not the glabellar area.  Injecting the glabellar area will not help to correct your forehead wrinkles because you will be targeting the incorrect muscles. Regards, Anil Shah 

The most likely patient to be unhappy with neurotoxin treatment (Botox, Dysport, Xeomin) is the under-treated patient.  As Dr. Naficy pointed out, the concept of "spreading around units" is nothing but a waste of money.  Just as you would treat a headache with the appropriate dose of Ibuprofen, undertreating muscle activity with toxins leads to minimal or no result.  I have never seen a patient have an acceptable response with Botox with less than 20 units per area.

Botox is a drug that is placed into the particular muscle to stop that muscle from moving  Treat the area that you are having an issue with.  Cheap usually winds up being expensive as you won't get the result that you want. 

A common misconception about Botox is that a patient can spread units around - keeping overall units used low (and costs lower), yet still treating several areas of the face.  If you try this, you will only waste the money you are trying to save.  If you are trying to save money, my advice would be to choose the single area of your face that bothers you the most (i.e. crows feet, forehead lines etc) and treat that area, but treat with enough units where you will actually achieve the result you are seeking.  The goal is for you to be happy with the outcome and for the product to work for you.  30 units total should be enough to effectively treat the glabella (20units) and the crows feet (10units) in most patients.  If you want to continue treating your forehead lines as well, you should use additional units - otherwise you will likely not be completely satisfied with your results.   

In general, to achieve a harmonious and balanced result in the forehead, most patients need a little Botox in the glabella and forehead.  You will probably not get the same results if you inject the glabella and not the forehead, especially if you have had forehead Botox injections in the past. 

 

As a way to save money, you can request fewer units.  Another option would be to get your normal 28 units, but then spread some units in the forehead AND the glabella.  Best of luck to you!

 

Roy Kim, MD

Hi makeitadouble.  The glabella is almost universally 20 units unless you are male or have extremely strong facial musculature in this area.  The crow's feet varies a bit more depending on the patient, but we are usually injecting between 15- 25 units in this area.  So, based on what you are currently having injected, we would provide a heavier dose for you for the areas you have interest in.

There are two other points we would like to address.  The first is how good your results are.  Botox results should last 3-4 months.  In most cases when you are under dosed, the results simply do not last as long.  Have your results been lasting this long?  If not, you may not be saving any money at the 28 unit level.

The second is whether or not you need the glabella treated.  It appears from the picture that you may not.  We do not see the vertical "11" lines in the glabella area and wonder if you should just stick the the current areas you are treating.  Hope this helps and good luck.

The musculature of the glabella and forehead are different, meaning where the Botox Cosmetic is injected is where it will work. You can decide with your injector which area is going to give you the maximum result. Because of the budget constraints, we would determine what area is bothering you the most and then  treat that particular area.  Visit our website for more information about Botox Cosmetic. 

Hi Make it a Double,

The injection of Botox is an art that should be individualized to each patient depending on their anatomy, the mass of their muscles, and their concerns.  From your photo, you look beautiful (despite your love of imbidation) doing what you are doing.  By treating your forehead only, your eye brows are probably a little lower than they would be if you also treated your glabella.  Glabella treatment is mainly used for the vertical angry "11" lines.

Good luck and be well (cheers!),

Dr. P

Botox is usually a home-run in the area of the glabella  (frown lines) and also in the crow's feet region.  In general, more of the patients I see are interested in these two areas as compared to forehead.  That said,  Botox treatments need to be customized to each individual.

If you are happy with the results of your current treatment pattern and you do not see much in the way of frown lines,  then continuing with what has been working for you is probably your best bet.  On the other hand,  if dynamic frown lines are an issue,  then Botox in the glabella would probably work very well for you.

Hope this helps.

Mark Lucarelli, MD FACS

Madison, WI