Can over treating the frontalis muscle with Botox lead to a weaker brow ridge?

Question

Through atropy of the muscle, will the visible brow bone/ridge/muscle that sits above the eye reduce?

Anna Chacon, MD, FAAD · Answer

Hi! This is a thoughtful question, and it’s something I hear from patients concerned about long-term effects of Botox on facial structure. Here’s what you should know:

Botox and muscle atrophy – When the frontalis muscle (the one that lifts your eyebrows) is repeatedly treated, it can temporarily weaken or shrink from disuse. This is called disuse atrophy. Over time, if treated aggressively or too frequently, the muscle may appear slightly softer or less prominent.

Effect on the brow ridge – Botox does not change the underlying bone structure. Your brow bone itself will not shrink or flatten because of Botox—the bone is permanent. What may change is the appearance of the overlying muscle, making the forehead look smoother or the brow slightly lower if over-treated.

Visible changes – The reduction you might notice is mostly softening of the muscle contour, rather than true loss of the brow ridge. In most cases, the effect is subtle and reversible; if Botox is paused, the muscle will gradually regain its tone and movement.

Balancing treatment – Careful, conservative dosing can maintain natural movement while still addressing forehead lines. Over-treating can lead to a flatter, heavier-looking brow, but this is usually a cosmetic appearance issue rather than a structural one.

In short, repeated Botox can slightly reduce muscle bulk and change the soft tissue contour above the eye, but it does not reduce the bone itself. The brow ridge remains intact, and most changes are reversible if treatment is adjusted or paused.

Anil R. Shah, MD · Answer

If muscle atrophy occurs, the soft tissue over the brow can become slightly thinner, which may make the area look a bit flatter or less full. However, the underlying bony ridge of the Supraorbital ridge will not shrink, so the overall brow prominence usually changes very little.

Gary DeCesare, MD · Answer

Muscles do atrophy, or become smaller in thickness, if chronically underutilized. However, the frontalis is transitioning to the muscle around the eye, called the orbicularis oculi, at the level of the eyebrow, so it is already very thin at that level. And therefore doesn't contribute much of the thickness of the tissue overlying the bone.

Can over treating the frontalis muscle with Botox lead to a weaker brow ridge?

Answers (3)

More Botox Questions

Ugly looking indentation on my forehead - how can this be improved? (Photo)

Can botox be used to drop an upturned nasal tip?

Jaw Asymmetry - could Botox help or will surgery be needed? (Photos)

Is it botox I'm looking for or something else? (Photos)

Can Botox cause hair loss?

How much masseter Botox would I need for my asymmetrical face?

WE SEND PRETTY
EMAILS