If I want Botox on my horizontal forehead lines do I also need between my eyebrows done to keep my forehead from drooping?

You can treat the forehead in isolation but you run the risk of the glabellar region becoming more pronounced because the only muscle group resisting it has been weakened. So for most patient I recommend treating both areas at the same time. 

Yes, it is possible to treat just the forehead BUT I usually suggest treating both at the same time to avoid hypertrophy or over-activity in the untreated area as the 2 areas act in concert. If you only treat one area, you risk worsening the other area. If it's your first time getting Botox and you're nervous, you can start with one area. Once your nerves are calm and you're comfortable with Botox, you can treat the other area.The foregoing information provided is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition.

Not necessarily, but this will need an in-person evaluation. I suggest getting a consultation with a cosmetic dermatologist. Botox results last 3-4 months in this area. Hope this helps.

The fact that the frown muscles between the eyebrows and the mid and upper forehead muscles that make the horizontal lines are two different muscle groups is exactly why I treat these two opposing groups together. If only the forehead muscle is treated, then the opposing frown muscles which exert a pulling down motion will win out and pull the eyebrows down and with them the upper eyelids usually.  one loses the arch of the eyebrow and the upper eyelids become heavier. There are some exceptions in very young people and in some patients who only have one horizontal line which is relatively high in the forehead.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs. 

Botox is a type of neurotoxin that temporarily paralyzes muscles that receive the medicine. On the face, the typical areas to inject are the forehead, glabella (the “11’s”) and crow’s feet. There are more expert injections such as in the lip, lower face, masseter muscle, neck, etc. to achieve different objectives. It is not only about the number of units injected, but where they are injected such as depth and which aspect of the muscle that ultimately dictates the final outcome.Botox and the other neurotoxins will start to take effect in 2-3 days, with peak effect at 2 weeks and will start to fade in 2-3 months. Risks of injection may include bruising, swelling, weakening of adjacent muscles.The answer to your question is no. The person injecting the forehead needs to know how to carefully do so to avoid dropping the brows.Consult with an experienced neurotoxin injector for a complete range of options that are appropriate for your situation.
Gary Linkov, MD
Facial Plastic Surgeon in Manhattan

Hello and thanks for the question.  In my experience the forehead and glabella (frown lines between eyebrows) do not necessarily need to be treated in conjunction. They are separate muscle groups and it really depends on which issue is bothersome to the patient. If eyebrow droop is a concern just inform you doctor and a slightly technique technique and dosage can be used. Good luck.

Please watch the video below. I try to explain some key aspects of the technicalities of using or getting botox. It really does make a difference who is injecting, how much and where it is injected. It is one of those treatments that unfortunately has become a commodity and it really requires a bit more of an artistic finesse approach ini my mind.  
We use the neuromodulators to target and soften the muscle groups without giving that frozen look.
Hope this helps,
Best of luck,
DrC

Hi, Thank you for posting your question. You can skip the glabellar complex [between the eyebrows] while injecting a very minimal dose concentrating forehead. After a week you can check for the eyebrow droop and do the glabella if necessary. But it is advisable to get your glabella done along with forehaed to get the desired results.  

Yes, you will need to get botox between your eyebrows first. If\ it is your first time to get botox you do not want to start with your forehead lines. In between the brows should be done first to ensure that there will not be any drooping. After two weeks you can have  a follow up appointment and potentially move foreward with the lines on your forehead. 

Thank you for your question drebeirn. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.The pivotal studies used 20 units of Botox in the forehead area above the brows to address the horizontal lines seen when one raises the brows. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary.The pivotal studies for the horizontal lines on the upper forehead were published many years after doctors had been using Botox. In these studies, 20 units of Botox were used to treat this area. However, in my experience I find that anywhere from 10 to 20 units works well in this area. For patients with narrow foreheads a lower dose may be used and those with a broad forehead generally require higher doses. I have also found that the full results in this area are seen by two weeks. Therefore, we have our patients return two weeks after their treatment to assess the results via photographs. At that point additional units may be used if further enhancement is desired.When patients present with concerns about specific wrinkles in the upper face such as the frown lines, I always assess and usually treat the other wrinkles in the upper face including the horizontal forehead wrinkles and crow’s feet. The reason is to maintain a harmonious and natural balance to the appearance of the upper face. The muscles in the glabella which are responsible for the formation of the frown lines serve to pull down on the inner brows when a person frowns. Similarly, the muscles around the eyes which are responsible for the formation of the crow’s feet seen when smiling (orbicularis oculi) are also responsible for pulling down on the brows, but in this case the outer brows. On the other hand, the muscle in the upper forehead which is responsible for the formation of the horizontal forehead wrinkles when a person raises the brows (frontalis) serves to pull the brows upward. If one of these muscles is relaxed with Botox and the others are not, the other muscles will still be active. This will lead to an unbalanced and unnatural appearance of the upper face where the brow can be elevated, depressed, or uneven in shape or position. Therefore, I recommend that my patients take a global approach to the upper face when receiving Botox treatments and treat all three of these areas. Sometimes bunny lines on the bridge of the nose are also treated.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!