that is a great question. I actually recently wrote a three part editorial series on forehead lifting and you may find it helpful. It discusses different options as well as why one may choose Botox over a Lift and vice versa.
Hopefully you find it interesting.
James P. Bonaparte.
Cosmetic and Reconstrcutive Surgeon
Head and Neck Surgery
Ottawa, Ontario, Canada
Botox certainly is an effective treatment of forehead wrinkles. The advantages are that it is safe, quick to perform and does not require any "down time." However, a forehead lift can achieve the same reduction in wrinkle permanently if the right technique is used. There has been a lot of push to perform procedures endscopically (smaller incisions), however when it comes to forehead lifts I think the open approach is better. If the incisions are made properly the scars are near invisible and the muscles in the forehead can be addressed much more definitively. This means that the wrinkles can be prevented for essentially forever. So although there is a healing process to a forehead lift it is a great long- term solution.
Consider an in-person evaluation or try submitting some images, which are very helpful with a question like this. Typically the two are not interchangeable - one being used for positioning of the brow, one being used for dynamic wrinkles (wrinkles when you move your forehead). For wrinkles present at rest, I typically consider some other options such as resurfacing or natural collagen to improve the depth of the wrinkles. Again you have a number of options - a consultation with a board certified physician would be a great first step.
Botox is great for wrinkles, a browlift is good for lifting sagging brows. A browlift is not a wrinkle treatment.
This is a good question because it's a common one that many patients ask. Neurotoxins like Botox are great at wrinkle reduction and prevention with minimal discomfort, downtime, and cost. The problem for patients is that you have to have repeated treatments essentially for a lifetime if you want to maintain the wrinkless state. If you are still seeing fine lines, as you mention, you may need more frequent treatments or more Botox units per treatment, because if both of these are satisfied, you should not see any fine lines, especially if you've been treated in the past many times. First time Botox treatment may not eliminate all the "static" wrinkles (wrinkles present despite facial animation) initially, but repeated treatments even smooth those out. A forehead lift is great for a more complete forehead rejuvenation including treating the muscles that produce the wrinkles and elevation of sagging brows. Obviously it's surgery, so the downtime, discomfort, cost, and risks are higher than Botox treatment. Despite what you may have heard, wrinkles after a forehead lift do eventually come back to some degree and may need to be treated with Botox anyway. So ultimately you have to weigh out all those things and decide along with your plastic surgeon which is the best option. Good luck.
Both options are good. The main reason to go forward with a browlift is to elevate the sagging brows. If getting rid of the wrinkles is the main desire then Botox is a decent ongoing treatment choice. But when you have those saggy brows, browlift is an excellent answer.
Thanks for the question. I wish you had included pictures to see what you meant by saying you wanted a forehead "reduction".
I have been using Botox injections to modify brow posture and wrinkle status for almost 15 years, and we can usually mute the wrinkles nicely, while also getting some brow elevation, which can give a more relaxed, refreshed look, and, in fact, this combination of injection sites can simulate the look we can achieve with a forehead lift. Certainly, the forehead lift is a more thorough rejuvenation of the upper face, but is a surgery, so it is quite a bit more expensive than any combination of Botox injections--but is longer lasting and generally worth the expense. And, if the forehead lift incision is brought out from its starting point within the scalp and continued in the hairline at the center of the forehead, the "slack" removed there when the forehead is "pulled up" is extra forehead skin, and this is then removed, so that will decrease the forehead skin height--so, if this is what you want for a "forehead reduction", you'll get it all--brow elevation, elimination of the "frown lines" and a "lowering" of the frontal hairline (plus taking out the "crowding" in the upper eyelids, and, in many cases, improvement in the contour of the nasal bridge)--and Botox can't do most of that for you. Talk with a Board-certified Plastic Surgeon who does full "coronal" forehead lifts for full information about your options. Good luck with your decision!
A Forehead lift can be performed for a variety of reasons which include low eyebrows, asymmetrical eyebrows, softening the frontalis wrinkles, corrugator wrinkles and raising or lowering the hairline. A full set of pictures and in-person examination and consultation is required to determine the proper course of treatment. For many examples, please see the link and the video below
A properly done and properly healed lift can always deliver more than what the Botox can, specially if a forehead reduction is part of the plan. Patients who have a great deal of wrinkles in the forehead usually have compensation of the forehead for the eyelid related problems. You may want to consult someone experienced who can detect and correct all of these at the same time. You could choose a local expert and if you are not satisfied, many of us offer Skype or FaceTime consultation for the patients from long distance.
drakingson, in general the older you get the less benefit you get from Botox (and fillers for that matter). Only a visit with and experienced facial plastic expert will give you the answer you desire. You could however just try Botox and if that makes you happy then continue until it doesn't! Good luck!