Where should Botox be placed for forehead horizontal lines?

Generally for horizontal forehead lines the botox will be placed in the 11's area (in between brows) and also in the upper 2/3 of the forehead- although this can vary depending on the individual.  If you are unhappy with your results see your provider for a touch up.

When you contract your frontalis (forehead) muscle, it creates horizontal lines.  Botox, as well as other neuromodulators, can be used to paralyze areas of the frontalis muscle to decrease those horizontal lines. While I always individualize my treatment regimen, the typical injection plan for a forehead involves using about 20 units of Botox. I ask the patient to create the horizontal lines by raising their eyebrows.  Then I inject in small amounts (about 1 unit per injection site) in lines across the upper part of the forehead. I usually inject in two parallel lines.  Typically the lower part of the forehead is avoided for two reasons.  First, if you inject the entire forehead, it can give the individual a frozen, unnatural look. Secondly, injecting lower on the forehead puts the patient at greater risk of having heavier brows that hang low.  This is typically more of an issue in older individuals.  The injection pattern can also be modified if someone wants to shape his or her eyebrows.  The short answer to your question is that you could have a few more units injected right into the area where you still have some wrinkles if your doctor feels that is safe and a good idea. 

Thank you for your question. Botox injections to soften the forehead lines vary from patient to patient depending on their frontalis muscle dynamics. Your injector can treat your horizontal forehead wrinkles by carefully placing a few units into the lower part of your forehead. This should not lead to more wrinkles above your eyebrows. I recommend having a follow up with your injector for some touch ups. Best of Luck!

Thank you for your question Newyorkers. Botox is a purified protein used to address wrinkles associated with
facial expression such as the horizontal lines seen on the upper forehead when one raises the brows. Botox works by relaxing the muscles. Therefore it is placed in the muscle. There is considerable anatomic variation in the upper forehead area and the placement is determined by visualizing the areas that move when raising and relaxing the brows. Please consult with a doctor for specific recommendations. Good luck!

Hi,  Your injector took the safe route by placing Botox in the top half of your forehead.  The risk when it is placed lower is that it will knock out the muscles that raise your eyebrows leaving you with heavy brows.   The only way treat your horizontal forehead wrinkles without leading to more wrinkles above your eyebrows is for your injector to very carefully place a few micro-units in the lower part of your forehead.  Keep in mind that while this will reduce those wrinkles above the eyebrows, it will also wear off faster than the rest of your Botox because such a small amount is used there.

Dear Newyorkers1:Botox injections for the purpose of softening forehead lines vary from patient to patient dependant upon their frontalis muscle dynamics.  Please see an expert injector for best results.  Best wishes.

Thanks for the question.  This is probably the area of Botox treatment with the highest potential for dissatisfaction.  Knowledge of the brow anatomy is vital to understanding the nuances of treating the forehead with Botox.  Wrinkles are created in a perpendicular direction to the underlying muscle on the face.  In the case of the forehead, the frontalis muscle fibers are vertical in orientation resulting in the forehead horizontal lines.  Botox to the forehead (frontalis muscle) paralyzes this muscle resulting in elimination of the horizontal lines.  The reason why this has a potential for dissatisfaction is that this muscle is also responsible for the resting position of the brows.  If it is paralyzed completely, the brows will drop.  This is especially important in patients with low brows to begin with.  The closer to the brows the muscle is paralyzed, the greater the potential for lowering the brows.  This can also be asymmetrical.  In my 12 years of doing Botox, this is the number one area of dissatisfaction in patients who have had Botox.  My advice is to stay conservative on the treatments and avoid trying to eliminate every horizontal line which places you at greater risk of affecting your brow position.

The placement of forehead Botox is very patient dependent. My approach is placing multiple small quantities of Botox throughout the forehead so as to give the most effective results with the least amount of Botox. It also gives the smoothest results. If larges doses are placed in fewer areas, there is potential to miss some areas and get uneven results as you describe. The small "commas" above the eyebrows are hard to treat but can be done with very minute quantities of Botox. If done properly, the brow should not be dropped.

Without seeing any pictures, I can only make n educated guess as to what you need. I think a little more Botox into the lines above your eyebrows will help. However, be aware that treating the horizontal lines of the forehead can cause drooping eyebrows which can lead to increased upper eyelid skin.

Thank you for asking the question.
BOTOX for horizontal wrinkle lines are placed depending on the lines present. There is no real set pattern but generally 8 to 10 spots in a triangular fashion are placed. Usually 2 are placed in the center and similarly 2 on the either side of the center, approximately 1.5 cm to 2 cm, and another 2 by another 1.5 cm to 2 cm by the side of the second line. Then for shaping the eye-brows, the Doctor may choose to use more spots. This is a general pattern. However, it may be changed for patients according to their needs.

Regards, Dr. Amit Gupta