Male, 36, prominent supraorbital ridge: Daxxify high placement → demarcation cliff at Day 15. Technique options? (Photo)

Question

Male, 36, NYC. Complex anatomy: prominent supraorbital ridge, brows at/below orbital rim, strong frontalis. Botox history -- every session produced medial brow droop. Switched injectors and got Daxxify. Last time had Daxxify upper frontalis only + glabella. Day 14: upper forehead frozen, lower frontalis was compensating heavily. Visible horizontal cliff at the boundary between frozen upper and active lower zones. Right frontalis more active than left — asymmetric line extended further right. Three questions: 1. What technique adjustments for this anatomy — specifically Daxxify vs. Botox placement strategy? 2. Is Microbotox (intradermal, superficial fibers only) appropriate here to address lower frontalis without eyelid / brow ptosis risk? 3. Should skip frontalis entirely and maximize glabella dose to reduce frontalis strain reflexively? Thanks!

Anna Chacon, MD, FAAD · Answer

You described this really well—and honestly, what happened to you is something I see pretty often with this kind of anatomy.

When someone has a strong frontalis and naturally lower-set brows, that muscle is doing double duty—it’s not just making expression lines, it’s also holding your brows up. So when the upper part gets treated and the lower part is left alone, the lower fibers kick in harder… and that’s where that “cliff” comes from.

I don’t think this is a Daxxify vs. Botox issue as much as a placement and balance issue.

How I’d adjust the technique

I wouldn’t isolate the upper forehead like that. Instead, I’d:

Treat the entire frontalis very lightly, not just the top
Keep the lower forehead very conservative, but not untreated
Basically “feather” the dosing so there’s no hard line between treated and untreated areas

That harsh transition is what created the visible step-off you noticed.

With Daxxify, I’m even more cautious because it can feel stronger and last longer—so if the balance is off, you’ll see it more clearly and for longer.

Microbotox for the lower forehead

Yes—this is actually where I think microbotox makes a lot of sense.

If done properly (very superficial, very small amounts), it can:

Soften that lower frontalis activity
Blend the transition
Without dropping your brows

The key is keeping it light. Too deep or too much, and you’ll feel heavy pretty quickly.

Skipping the frontalis altogether?

I wouldn’t.

If you only treat the glabella and ignore the frontalis, in someone like you, the frontalis often ends up working harder, not less. That can make things look even more uneven.

What I would do is:

Treat the glabella well to reduce that downward pull
Then balance the frontalis, not avoid it
If you were in my chair

I’d go for a really controlled, blended approach—not trying to freeze your forehead, just smooth it without taking away its support function.

The goal is that nothing stands out—no cliff, no heaviness, no asymmetry—just a softer, more even look that still moves naturally.

What you experienced isn’t uncommon, and it’s fixable with better distribution next time.

Male, 36, prominent supraorbital ridge: Daxxify high placement → demarcation cliff at Day 15. Technique options? (Photo)

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