Forehead Lines. Options to Keep The Muscle Less Active Permanently?

I am a 31 year male and have three small lines on the left side of my forehead. Through research I have read that during a brow lift the frontalis muscle which lifts the brows and causes the horizontal lines can be weakened or altered to minimize the muscle movement. Some sites say that the weakening/removal lasts permanently and others that it lasts a few years. I was wondering which it is, I would be interested in a procedure to keep the muscle less active permanently in a few years.

Doctor Answers 11

Subtle use of botox

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Subtle use of botox is a much more reasonable way to address your concern at this point in your life. It can soften the lines you talk about without completely paralyzing the forehead.

A browlift can be considered when you are much older.

Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Forehead lines

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I would recommend using botox or dysport first to paralyze the muscle. If you like the look then the muscle can be divided. Even with the division with time the function does return partially

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

Brow lift to address forehead lines

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A brow lift is performed to raise eyebrows and to soften the musculature of the forehead.  If needed the frontalis muscle is one of the muscles that can be softened at the time of the forehead lift.  The degree of softening of the forehead frontalis muscle depends upon the patient’s and surgeon’s needs, goals, and desires are.  The amount of reduction and movement of the muscle is totally controllable and once the muscle is softened it is a permanent solution.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

How to permanently correct forehead lines

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The old fashioned open browlift that then cut portions of the muscle out was pretty good at permanently eliminating forehead wrinkles. it must be done well though or it can leave some irregularities. The only other way is to paralyze the muscle through either Botulinum Toxin or by cutting the nerve (the latter is not generally recommended).

Forehead Lines. Options to Keep The Muscle Less Active Permanently?

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The muscles can be clipped to weaken them somewhat, ususally this procedure is done during a brow lift.  Botox is a good option to use if you are not ready for a brow lift. 

Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

Permanent control of forehead muscles

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First of all, be careful of any procedure that is "permanent". We live, we age, and what seems like a great permanent idea now may not be such a good idea 20 later. I tell my patients that the only things that are permanent is scars. The fact that a treatment is not permanent may be a God-send if the initial result is not what you hoped for. Botox/Dysport injections are temporary with the length of paralysis depending mostly on the activity of the muscle area. Surgically cutting of the nerves to a specific  area, which I have tried, and hoping for a permanent result is very difficult as the nerves are microscopic and, as many nerve injured patients hope, they do grow back. Treat the problem that you have today.    

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Results with surgery not permanent

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Even with surgicall division of the forehead muscles function will eventually return. As a fairly young patient it would be much safer for you  to use Botox to relax the muscles rather than undergoing a surgical procedure. Both are temporary but the Botox is much lower risk. 

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 114 reviews

Browlift and forehead frown lines

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It would be helpful to see a picture, which would allow me to give better advice.


Why do forehead lines come about in the first place?  Most commonly the lines develop when the brows have begun to settle and crowd onto the upper eyelid.  There is a subconscious reflex that occurs in which  the frontalis muscle, the main brow elevator, lifts the brow off the eyelid.   With time this activity causes horizontal creases across the forehead.  Years ago there was the mistaken assumption that it was necessary to cut across the frontalis muscle in order to reduce forehead lines.  In fact, when the brows are brought back to a proper position, the frontalis muscle doesn't have to work as hard, so the forehead lines tend to soften and even sometimes disappear.  There are a number of other causes of horizontal forehead creases, but the reflex I have just described is the most common one.


Botox can be used to soften forehead creases, but it must be injected judiciously in order to avoid weakening the brow elevators and dropping the brow position.  Often it is necessary to block the frown muscles between the brows and out near the corner of the eyes at the same time that the forehead elevators are weakened in order to keep the brow in a proper position.


From your description of three small lines, it sounds like you are a little early for a browlift.  It is probably better to make careful use of botox, but only by a highly experienced injector.  Please don't overtreat.  I don't understand why some doctors and patients think a frozen, inexpressive forehead looks good.  Another option may be just to accept things as they are if the lines really are minimal.

John Q. Cook, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 12 reviews

Forehead Lines. Options to Keep The Muscle Less Active Permanently?

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 It's true that with a Brow LIft the frontalis muscles can be resected to decrease forehead lines and wrinkles however this is a secondary benefit of a Brow Lift and not the primary function of the surgery.  The primary reason for a Brow Lift is to raise eyebrows to a higher, more aesthetic position.  

 Today, with Botox and Dysport injections that are easy, safe and highly would be very difficult (I hope) for you to find a plastic and cosmetic surgeon that would perform a Brow Lift on you to soften these forehead lines alone as a criteria for surgery.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Forehead Lines. Options to Keep The Muscle Less Active Permanently?

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Beside open forehead lift with frontalis muscle weakening, subcision of fronthead lines with microfat transfer as well as endoscopic forehead lift can improve the forehead lines.

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon

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.