Scared of Botox For Forehead Lines- What Are The Risks?

Hi, I am 29 and I have horizontal forehead lines on my forehead that make me look older. I would love to have botox but im terrified of it. what are the chances of breathing probs or swallowing probs after having botox in the forehead?? If this were to happen when would it be apparent? would the risk be for the whole 4 months or so that botox works or for the first few day?? thanks

Doctor Answers 15

Botox is safe for forehead lines

There are always some risks with every procedure, but Botox has been done for more than two decades with a very high safety profile.  Horizontal lines can be treated well in young individuals, but unfortunately, as one ages, the whole forehead and eyelids sag and botox injected to make the forehead smoother will relax those muscles and the eyebrows and eyeldis can sag more. Therefore, some people can only have a few, not all lines treated.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 36 reviews

Botox for forehead lines

Dear andrea3238: There is no risk whatsoever regarding breathing/swallowing problems with Botox injections in the forehead. The usual number of units is 6-12 units in this area. The only concern is drooping of the eyebrows, if the injections are done by an inexperienced injector.

The problems with swallowing/breathing occur when deep injections or  a large number of units are injected in the neck area

Always look for an experienced board-certified dermatologist/plastic surgeon/ophthalmologist to be assured about a good result with no complications.

Khaled El-Hoshy, MD
Detroit Dermatologic Surgeon

Botox in Forehead Is Safe

Botox has been used since the 1990s to treat wrinkles, such as those that bother you in your forehead. While every procedure has some risks, the risk profile for Botox is very low – especially in the forehead, where only a few units are used at a time. The reports of shallow breathing and swallowing problems have been limited to Botox in the neck and are probably owing to over-injection. The main risk for Botox in the forehead is that an inexpert injector may cause the forehead to sag. This is why it is important to find someone with experience and expertise. I hope this helps

Botox in forehead

BOTOX IN THE forehead is generally very safe. The most common side effects typically involve heaviness in the brows from injecting a bit too much in THE forehead. There is really no risk of breathing and swallowing problems when injectinhe small quantities typically used for aesthetics.

Ritu Saini, MD
New York Dermatologic Surgeon
4.5 out of 5 stars 8 reviews

Serious Botox Risks

I have used Botox for 15 years and have NEVER encountered serious Botox complications.

Although such complications as hoarseness, difficulty swallowing etc have been seen they are seen in 3 sets of patients:
- those requiring LARGE (over 100 units) doses of Botox (such as those with spastic disorders)
- those receiving large orders by using gray market "Botox" (a few years ago a Florida physician with an expired license injected several people including himself and his girlfriend with large doses of Botox and required being on a ventilator)
- people with Neuromuscular disorders (such as Eaton-Lambert, Myasthenia Gravis etc) whose muscles are overly senstive to Botox OR people taking certain medications which MAKE them more sensitive to Botox

Finally poor technique, most commonly by nurses / aestheticians / injectors even non- "core" doctors may result in poor results but less commonly in the complications you are worried about.

The treatment of forehead creases is straight forward in most people. But if you cannot shake your fear, it may just not be for you.

Peter A Aldea, MD
Memphis, TN

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 101 reviews

Botox for forehead lines

Botox is a common and safe treatment for various areas of the face including forehead lines. Side effects from treating this area are uncommon, mostly a small bruise or headache in a small percentage of patients. Less commonly a "spock brow" or slight drooping of  the eyebrows can occur. All side effects are temporary, and rare in expert hands such as a dermatologist or plastic surgeon.

Benjamin Barankin, MD
Toronto Dermatologic Surgeon
4.9 out of 5 stars 42 reviews


Botox is very safe. Patients only get swallowing problems when extremely large doses are used which is  not common with facial treatment.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Botox Cosmetic complications are extremely rare

Having Botox for forehead lines is one of the most commonly performed cosmetic procedures.  It is perfectly safe as long as you have a properly trained physician or a nurse (under a physician's supervision) performing the injection.  Make sure you go to a reputable place using authentic Botox

The complications you described occur when massive doses of botox are used for patients with cerebral palsy.  They use thousands of units.  For a forehead you would get 10-20 units. 


Martin Jugenburg, MD, FRCSC (Toronto Cosmetic Surgery Institute)

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 415 reviews

Risks of Botox Cosmetic

The primary risk of a significant adverse outcome resulting from your pursuit of Botox Cosmetic is the danger of being in a traffic accident driving to or from the appointment.

No one has ever suffered a permanent disability from Botox Cosmetic.  Serious adverse events from the use of Botox are extremely unusual and have not been from use for cosmetic purposes but rather when used in very large quantities for challenging problems such as muscle spasms in people with debilitating neuro-muscular disorders (like CP).  There have been serious adverse events using non-medical grade or counterfeit botulinum products, but that would be unfair to include in a discussion of one of the FDA approved products including Botox, Dysport, and Xeomin.

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
4.9 out of 5 stars 29 reviews

For cosmetic BOTOX the risk of a systemic side effect is very low.

BOTOX has proven to be a very safe treatment.  What are the odds of developing a swallowing or breathing issue?  In my practice commonly using a dose of 33 units of BOTOX, it appears to be less than one case in 2000 treatments.  That is not zero.  So it is true that you have a better chance of having a swallowing problem after a BOTOX treatment than winning the California lottery.  However, still this is a very safe treatment and results can rival the effects of surgery.  If you did get a side effect it is generally apparent for a few weeks and then subsides.  Still side effects are not welcome.  Patients who experience them generally should avoid retreatment.  Still that leaves tens of millions of people who love their BOTOX.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

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.