Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Drooping Glabella / Medial Brow following Botox for Horizontal Forehead Lines

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

A. Great observation! Botox is an injectable muscle weakener. Botox injection is art and science. The production of the medication is the science. The rebalancing of muscles of expression, injection amount, injection sites and technique are the art.

  • The 2 frontalis muscles directly above the brows elevate them upwardly and create lateral forehead wrinkling.  
  • The 1 round muscle around the eyes called the orbicularis oculi muscle pulls the medial brows down and in as well as down and out.
  • 4 muscles in the glabella: corregator, depressor supercilis, procerus and orbicularis pull the brows down and inward.

The central forehead wrinkles are either due to lift by the frontalis muscles with downward pull by gravity or lift from some frontalis fibers.

The desired effects of Botox on the forehead expression lines are to:

  1. Reduce glabella wrinkling
  2. Reduce central forehead wrinkling
  3. Individualize elevation of the medial, middle and lateral brow
  4. Weaken the upper, outer “crow’s feet” active wrinkles
  5. Weaken the vertical upper eyelid fan-like active wrinkles

I am sure you can appreciate the artistic and skillful talent required to achieve these desired effects when individuals have such a spectrum of muscle pull, skin texture and wrinkles, sun-damage and weathering, short and long foreheads, different presentations of expression, anatomy and unique muscles weaving and skin insertion.

Now, to answer your question. Botox to the glabella and lateral brow muscles will allow the brows to elevate. Botox to the central forehead wrinkle lines may weaken the forehead elevation reducing the wrinkles but allowing gravity to pull down the central brow and in some patients creating a upper nose fold.  

I cannot anticipate your results so please consult with a talented, Board Certified Plastic Surgeon with proper skills for this artful technique. I wish you the best.

Read more about similar topics:

Botox Brow Lift

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

Give us a call at  410.602.3322  or email and make an appointment soon. We’re located on Reservoir Circle just a block off the Baltimore beltway, convenient to greater Baltimore, Annapolis, the Eastern Shore, Southern Pennsylvania, Delaware and Carroll County.

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