Indentation on my forehead which has remained paralysed. Evens out again with more treatment but appears again? (Photos)

Question

post Botox an indentation appear in my forehead, eased off slightly but at the end of 3 months was really bad . I went to a different practitioner who said that the centre ( dent) was still paralysed so didn't not injection there again I fixed around about the area ....area smoothed over again .went back again to same practitioner who injected again (missing that area again which (still paralysed) and has evened out again except one tiny indent ...almost like a fingerprint dent on forehead.

Jason Emer, MD · Answer

I suggest waiting till the botox wears off completely and comparing your before and after photos to determine what would be the best treatment option.  Fillers can be used to improve this area.  This looks more like your muscular shape some people have two frontalis muscles and overlap in the center creating this look.  Best, Dr. Emer.

Kenneth D. Steinsapir, MD · Answer

I recommend taking a break from botox.  Letting the treatments wear off and then looking for a Microdroplet Lift injector which is an alternative to freezing the forehead that does not cause the type of muscle recruitment issues you are having.

Kally Papantoniou, MD, FAAD · Answer

Great question and photos. It is likely that your first injector placed more units than needed into that area, which is why it was so paralyzed  in comparison to the surrounding areas. Successful Botox can be done so that deep expressions are not possible but slight movement still occurs for a natural look. The good news is that it is always temporary, with time it wears off and you don't have to worry. Best, Dr P.

Monika Soni, MD · Answer

Thank you for your question! I would advise you to wait it out for Botox to completely wear out. Find an expert with significant experience who will evaluate your before and after photos and maybe suggest you different treatment or will do future injections in different spots. It may be the case that you had too much Botox injected in this area. On the other hand, some people have two frontalis muscles, therefore Botox has to be strategically injected to avoid such occurrences. Best of luck!

Hardik Soni, MD · Answer

I would advise you to wait it out for Botox to completely wear out. Find an expert with significant experience who will evaluate your before and after photos and maybe suggest you different treatment or will do future injections in different spots. It may be the case that you had too much Botox injected in this area. On the other hand, some people have two frontalis muscles, therefore Botox has to be strategically injected to avoid such occurrences. Good luck!

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question nikopark23. I am sorry to hear about your situation. Botox is
a purified protein used to address wrinkles associated with facial expression. You did not state specifically which areas were treated with Botox. Therefore it is difficult to make an assessment. When I assess my patients for Botox treatments I look at various animations including raising the brows, frowning, and smiling. When treating the forehead area I recommend treating the frontalis, glabella, and orbicularis occuli at the same time. This prevents strange appearances such as those you describe. Some people have what is called a bifid frontalis muscle, meaning that the muscle is split in two parts, one on either side, as opposed to a single broad muscle spanning the forehead. This is seen when the wrinkles that appear when they raise their brows form in two curves, one on each side of the forehead. In these cases Botox usually does not need to be placed in the central part as there is no muscle there. Please consult with
a doctor for specific recommendations. Good luck!

Steven F. Weiner, MD · Answer

It appears that there was "overdosing" of Botox in the central portion of your forehead. Eventually, this will wear out and movement will return. Often glabellar injections will also treat the mid forehead and if more Botox is placed there, it is like getting double dosing there. If you don't want to go completely "bare" from Botox, I would continue doing the type of injections you are doing. Otherwise, let everything wear out and start again.

Michele S. Green, MD · Answer

Since Botox makes the skin "stretch" out, any irregularity on the surface on your skin can become more evident.  When your Botox wears off, the skin will go back to normal and the indentation not as visible.  If the dent bothers you I would suggest having Restylane into the area to fill in the indentation. Best, Dr. Green

Indentation on my forehead which has remained paralysed. Evens out again with more treatment but appears again? (Photos)

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