Why are my forehead wrinkled asymmetrical now? (Photos)

I received 10 units of xeomin in my forehead. None in the muscle between the eyes. Now my left eyebrow is a little lower and my forehead wrinkles are not symmetrical as you can see in the photo collage. I want my forehead wrinkles (that are visible when my face is resting) to go away BUT I don't want to be frozen. Is that possible (or is it one or the other? ) and what should I do about my weird asymmetrical forehead.

Doctor Answers 11

Xeoinin, units and technique.

Fillers and neuromodualtors like Botox, Juvederm, Xeomin, Dysport, Restylane are all products, much like a pair of high grade Japanese Scissors. Give the pair of scissors to a hair dresser who is an apprentice, compared to a director, and the outcomes, in most cases will be different. The answer lies in the technique but also the dose. 10 units for your muscle bulk is much too low. The solution? Your injector will - or should know how to correct the asymmetry and place another 10-14 units in strategic areas to give you the look you want. This is an easy fix. All the best, Dr Davin Lim. Brisbane. Australia. 

Brisbane Dermatologist
4.7 out of 5 stars 75 reviews


Thank you for your question. When did you receive the xeomin? Injectibles do need time to take effect, and the answer could be as easy as you need to remain patient for the procedure to take effect. You should also review your recovery expectations and instructions from your board certified facial plastic surgeon.

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 117 reviews

Multiple Factors

Hi there, 

Firstly, it is important to wait the full 2 weeks post-treatment to have an idea of exactly which areas were treated and to what extent. From there...

2) You may need additional units in your forehead as your frontalis muscle appears to be quite strong.

3) Finally, the frontalis muscle (the forehead muscle that creates horizontal lines) is large and flat; it is not uncommon to need a touch up to address minor areas of asymmetry.

I would follow up with your injector for additional treatment to achieve your desired results.

Philip A. Alves, MD
Toronto Physician
5.0 out of 5 stars 1 review


10 units is a small dose of Xeomin for the results you are looking for. You are only 5 days in and it will take at least 2 weeks to see the full effect of your current dose. I believe you will need additional units for the result you desire.

Kristin J. Tarbet MD, FACS
Bellevue Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Asymmetric wrinkles

Xeomin is one of three commonly used botulinum  toxins used to  freeze dymamic wrinkles. 10 units of Xeomin is a very small amount to  reduce wrinkles in the forehead. I find you can get an elevation of the brow by treating the lines between the brows and the tail of the brow.  Often treatment of the forehead alone can make the eyebrows stiff.  I think you can resolve your issue by treating the forehead and the  lines between your brows with more units.  I still recommend conservative amounts since you would like to have some movement.  All the best.  Dr. Jean Keamy

Jean Keamy, MD
Westborough Ophthalmologist
5.0 out of 5 stars 7 reviews


Your situation can easily be solved with a few additional units of Xeomin to weaken the side that is still moving.  It is also possible one side is stronger than the other. Ten units is a relatively conservative amount, but for some patients this may still result in very little muscle activity. I prefer to err on the side of more movement rather than less when I am first injecting a patient who is concerned about the “frozen” look because I can always add more Xeomin. The relationship between movement and lines is like a teeter totter - the more medicine that is injected, the less the muscle moves and the less obvious lines will be. The more you move, the more lines will be present. You have to decide where the balance lies for you individually to achieve the results you are looking for. I’d recommend consulting with a Board Certified Plastic Surgeon and expressing your desires.

Audrey A. Klenke, MD
Hilton Head Island Plastic Surgeon
5.0 out of 5 stars 6 reviews

Xeomin to forehead

Your photos suggest a need for additional Xeomin.  The initial dose may not have been injected evenly, causing asymmetry in muscle contraction.  Give the Xeomin a few more days to settle in, and follow up with your treating physician.  Good luck!  This is a pretty easy fix.

Inessa Fishman, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews


Hello Whitney1887,

Thank you for your question and your photos. 10 units of Xeomin to the forehead is very minimal. This can be corrected by adding additional units. You still can stay on the conservative side and not be "frozen". Hope this helps.

Best to you, Dr Faraz

Patricia Faraz, MD
Ladera Ranch OB/GYN
4.7 out of 5 stars 14 reviews

Forehead wrinkles

Your request for smooth skin on the forehead without being frozen is certainly possible. 10 units is a very small amount and it looks like even that was not distributed evenly. be sure you are seeing a board certified dermatologist or plastic surgeon

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 4 reviews

Forehead Wrinkles and Crows -- Botox, Lasers, Fillers, Needling; FILLERS LIKE JUVDERM, RESTYLANE, BELOTERO, FAT

Id suggest seeing an expert for treatment.  There are many options for improvement.  10 units is minimal to the forehead. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 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.