Botox for Static Wrinkles on the Forehead?

Question

I have static wrinkles on either side of my forehead. I usually have to raise my eyebrows because I do suffer from drooping eyelids. Should I get Botox for my forehead? I'm 20 years old. Thank you.

Anil R. Shah, MD · Answer

Great Question! It sounds like Botox would fix all of your concerns.  Botox is used to correct forehead wrinkles and is frequently used to lift the brow!   Typically, you get re-injected every 3-6 months, but you are never back to your baseline as of pre-treatment.  With every treatment, the appearance of your lines and wrinkles will become less noticeable.  
Regards Anil Shah

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

thank you for the question. There are two aspects to address here - one is the static lines and the second is the drooping eyelids. It would be adviasable to be seen by a plastic surgeon to assess whether firstly you would benefit from surgical treatment such as a blepharoplasty to address the drooping eyelids. If you talk while raising your eyebrows - the liklihood is that you would have excess skin under your eyebrow that is causing the hooding. The action of raising the eyebrows on speaking is quite common in these patients. It would also be important to address whether you would actually benefit from a brow lift rather than blepharoplasty and this would be determined on examination of your case by your plastic surgeon.With respect to static lines - these are better treated by filler or can be effective with a combination of botox or fillers. Botox is generally for active or dynamic lines. The concern with botox here is tht if you already have some droop - adding botox in this area will block the frontalis muscle totally and so you could worsen your droop as the frontalis will no longer be blocking the action of the orbicularis muscle around the eye which pulls the eyebrow downwards.I hope this is of help BW

Ron Shelton, MD · Answer

Sometimes when Botox is used for these lines, the lines improve but the eyebrows can drop too much. You might only be a candidate for a superficial fine filler for these lines. See an experience Botox injector for evaluation.

Otto Joseph Placik, MD · Answer

No I would not put any more Botox into your forehead. You are compensating for you eyelid problem by using your forehead. This allows you to achieve better vision. IF you inject your forehead, you may diminish the wirnkles or creases with time but your forehead will cause your brows to  lower which may aggravate the sagging (ptosis) of the upper eyelids and produce a visual field obstruction.
IT sounds as if you would achieve better results with an upper eyelid surgery. Once this is accomplished, your forehead will relax and the lines should soften.
You may want to discuss this with your opthalmologist to establish a diagnosis. There are many conditions which can lead to sagging o fthe upper lids and these should be evaluated.

Kenneth D. Steinsapir, MD · Answer

Dear Billabong girl
Your forehead muscle (frontalis) is working hard to over come the heavy upper eyelids.  The lines you see on the forehead are evidence of this work.  These are dynamic lines.  A static line is a crease in the skin that is present even when the muscles are at rest.
If you have some one BOTOX your forehead, your forehead will be smooth as glass (think Marcia Cross or Nichole Kidman).  However, you will pay an aesthetic price.  This treatment works by paralyzing the frontalis muscle.  So the forehead lines will be smooth but the the eye brows will drop like stones.
I have developed the microdropletTM forehead lift, a patent pending method of precisely treating the muscles that pull the eyebrow down.  These muscles live at the level of the eyebrows.  Treatment of this area needs to be precise and very superficial.  I use microdroplets of BOTOX solution to accomplish this treatment.  The result is that the eyebrow elevates and the forehead smooths because the muscles of the forehead don't have to work as hard to maintain the lift.

Richard Baxter, MD · Answer

From your description of how you have to raise your eyebrows because of heavy lids, you forehead wrinkles are due to contracting the frontalis muscle so they are actually dynamic. Botox is fairly tricky to use in this situation, because by relaxing that muscle you won't be able to raise your eyebrows as much. Consult someone with a lot of experience so that you can get the best advice. Sometimes botox can be used around the eyes in order to let the brow come up on its own even though the problem is manifest in the forehead.

Martie Gidon, MD, FRCPC, FAAD · Answer

No, you are not a candidate for Botox for your forehead. Since you are already raising your eyebrows, you would not be able to do it after Botox. Your eyelids would droop more, you would have a heavy sensation of your brow and you would not be happy. You would be a better candidate for filler into the lines. Please be assessed by a board certified dermatologist or plastic surgeon who would know how to assess your forehead.

Scott E. Kasden, MD, FACS · Answer

It is not common for me to hear people accurately describe their wrinkles.  Botox is indicated for "dynamic" rather than static wrinkles.  Static wrinkles are usually better treated by surgery or skin resurfacing.
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Botox for Static Wrinkles on the Forehead?

Answers (8)

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