Can I have a brow lift using Botox and treat forehead lines? How much needed to treat glabellar?

You have probably heard the admonitions "be careful what you ask for" and "you can't have your cake and eat it" (or a better one is "you can't have your Kate and Edith too"). Also, "you can't sit on two chairs" or "you can't dance at two weddings"!They all apply to your question!If you want the forehead lines, which are lines of motion, improved, then injecting a modicum of botulinum toxin will certainly give you relief. However, the frontalis muscle that raises the brows will now be in a relaxed position and the brows will drop! The more the botox in the forehead, the better the lines (to a point, of course) and the lower the brows (to a point, again). If, after you already have botox in your forehead muscles, you want the brows (which are now, surprise, surprise, heavy!) to be higher and you ask the surgeon to inject below the brows, you are putting too many vegetables in the casserole. You may (or may not) get some degree of a lift. It will be like spitting in the wind. So be careful what you ask for, and you can't have your .............Happy botoxing!Prof. Bhupendra C. K. Patel MD, FRCS

Thank you for your question. Shaping the brows is one my favorite parts of using Botox and it can be done at the same time as treating the forehead or frown lines. It requires a very detailed understanding of the underlying anatomy as well as assessing each individual while they are animating their brows. By carefully placing Botox in the muscles that depress the brow, you can cause the brow to rest and relax in a lifted position. There are limits to how much you can lift, and for some surgery is better option. Incorrect assessment or placement can also lead to the reverse effect, so overall technique is critical. You can also shape the brow different. For example, you can raise the tail of the brow vs creating a raised arched brow vs creating a raised horizontal brow. It depends on the individual's desired brow aesthetic goals. I would consider this a very advanced technique so I would query your injector on their experience in this area.
As far as how many units may be needed, this also depends on which part of the brow you want to correct. For the inner brows, you may consider ~20 units (same as the frown line treatment). For the middle or outer brow, I generally use up to 5 units on each side.
You may also want to consider adding fillers to shape and raise the brow. Combining the two products can work synergistically together.

Hello, this is a common question in our practice - the answer is often yes.Botox treatments are all about harmony and balance. The features you are trying to improve can be brought into harmony by affecting the balance of muscle forces working in those areas.The procedure as you now know, works by weakening the muscles that receive the injection. If those muscles are responsible for lines (forehead or crows feet) then weakening them will decrease or eliminate those lines temporarily.If those muscles are pulling an area down (lateral eyebrow or corner of the mouth), weakening them will allow other muscles in the area to "lift" unopposed. That is the basis for subtle brow lift using botox.Your case may be slightly different in that you have had a normal but significant treatment to your forehead muscle. Even if you weaken the downward pull with further injections you might not have much upward lifting power left to affect a significant change.Clarify your goals with your Plastic Surgeon. Most experienced injectors can use botox alone or with other treatments to obtain dramatic and pleasing results.Good luck to you.