Botox For Forehead Wrinkles At A Glance
Botox is a neurotoxin that weakens the muscles of the forehead and can thus smooth out forehead wrinkles.
Since Botox is metabolized by the body, its effects are temporary. The results typically last for 4–6 months, after which Botox needs to be injected into the forehead again.
Botox injections in the forehead do not require anesthesia.
Typical side effects include redness, swelling, and bruising. These usually subside within 2–3 days.
Botox injections in the forehead do not require any downtime. You can resume your normal activities immediately.
The initial treatment session typically lasts 30–45 minutes, while follow-up appointments usually take 10–20 minutes.
Everything About Botox For Forehead Wrinkles: The Topics
Smoothing Forehead Wrinkles – When and How Much?
Botox for Forehead: A Classic Approach
Removing forehead wrinkles was one of the first cosmetic applications of Botox. However, injecting the forehead is not a trivial matter. Naturally, forehead wrinkles have a positive significance. They appear when we are attentively listening or showing interest. Forehead wrinkles are immediately and clearly visible to others. By furrowing our brows, we signal active participation and empathy. This makes forehead wrinkles an important aspect of our emotional appearance.
Smoothing Forehead Wrinkles without Regret
As individuals, we appear authentic when our verbal and non-verbal communication aligns. While our conversation partners hear us verbally, they also observe us non-verbally. When someone expresses sadness about something, it is expected that they visibly furrow their brow. Failure to do so can come across as insincere.
When people say, “I’m proud of my wrinkles,” they typically refer to their authenticity. And it’s true: A functioning facial expression, including the ability to form forehead wrinkles, plays a significant role in projecting an authentic and sympathetic presence. In other words, being able to furrow our brows makes us likable.
When do Forehead Wrinkles Have a Negative Effect?
However, the positive impression fades when forehead wrinkles appear grim or unsympathetic. This is usually the case when they are consistently and prominently pronounced. Deep furrows that extend horizontally from one side of the forehead to the other rarely evoke sympathy. They create an introspective, doubtful impression, as if we are regarding others with skepticism or even disdain.
This particularly applies to the central forehead wrinkle between the eyebrows, aptly named the “frown line.” A deep frown line can significantly affect the way people perceive us and how we perceive ourselves. Recent research on the potential effects of Botox on depression primarily focuses on the treatment of the forehead and frown line.
Deep Forehead Wrinkles Convey Tiredness and Sagging
Deep forehead wrinkles also signal tiredness. We appear fatigued and lacking dynamism, making us appear older than we actually are. Since the forehead contributes disproportionately to our overall appearance, this impression is magnified. Other positively perceived facial expressions take a back seat when deep furrowing is the first thing noticed by others.
Once again, it is important to mention current research on Botox for depression. Under the negative impact of deep forehead wrinkles, individuals often suffer themselves. In such cases, cosmetic intervention not only improves one’s external appearance, but also enhances personal well-being.
Affordable Botox Treatment for the Forehead
One advantage of Botox for the forehead is its lower cost. Treating the forehead, frown line, or the entire face with Botox in a single session costs only a fraction of a surgical facelift. While surgical facelifts are often the preferred method for addressing skin sagging associated with aging, Botox is a more cost-effective method for treating forehead wrinkles caused by facial expressions. Typically, a single vial of Botox is sufficient for treating the forehead and frown line, resulting in relatively low costs, even in cities like Munich.
Minimal Risks with Botox
Furthermore, Botox for the forehead is a significantly safer method. There is a substantial difference between having your forehead treated with Botox during a lunch break or undergoing surgery under general anesthesia. Botox for forehead wrinkles takes only 20 minutes, and you can resume your normal activities afterward. Temporary redness and minor bruising are the primary risks associated with Botox. These risks are incomparable to those associated with surgical procedures. As a result, Botox for forehead wrinkles has become one of the most commonly performed cosmetic interventions worldwide.
Smooth Forehead Wrinkles Dynamically
Dynamic Smoothing
That’s why I advise my patients in Munich to only have their forehead wrinkles smoothed in moderation. This means in particular avoiding high doses of Botox injections in the forehead, especially in the large forehead muscle (Musculus Frontalis), which is primarily responsible for causing forehead wrinkles. This is to prevent the appearance of a frozen forehead. While it would make your forehead wonderfully smooth like in your younger years, it would also result in a lack of facial expression that may be perceived as a lack of empathy in various situations.
Forehead Wrinkles Should be Present When they Appear Sympathetic
Instead, my therapeutic goal when treating forehead wrinkles with Botox is to maintain the ability to dynamically express them. When you are surprised or particularly attentive, you can still show it to others by raising your forehead and creating light horizontal wrinkles. In all other situations where these wrinkles would be undesirable, they are not present.
Smooth Forehead Yes, Drooping Brows No!
Tired Look After Botox
If too much Botox has been injected into the forehead, one of the signs is drooping eyebrows. A so-called brow ptosis is one of the greatest risks of Botox injections in the forehead. It occurs when the frontalis muscle is excessively weakened. The frontalis muscle lifts the eyebrows up. If its pull becomes too weak, then its muscular antagonists pull the eyebrows down. Drooping eyebrows have a very disadvantageous visual effect. Affected patients often complain about “tired eyes after Botox” or a “tired look after Botox”. I’ll discuss this further below.
Low Dosage for Botox In the Forehead
Whenever possible, I opt for a low dosage of Botox in the forehead. This preserves facial expressions and prevents excessive weakening of individual muscles that would disrupt the balance of the face.
The standard scheme for Botox against forehead wrinkles today prescribes a single line of injection, from which I typically do not deviate. There are exceptions, such as cases where a high forehead requires a second row of injections. But otherwise, it is neither necessary nor desirable.
Lower Dose, lower Cost
In the past, the dose in the standard protocol was set quite high, with 30 units of toxin. However, today, aesthetic professionals are much more cautious. The recommended dose of Botox for the forehead is now only 13 units, less than half.
If the glabella and eyebrows are also treated, an additional 30 units are required, for a total of 43 units. A vial of Botox contains 50 units. The complete treatment of the upper face can therefore be comfortably performed.
Treating the entire forehead with Botox in one session is therefore attractive in terms of cost. The active ingredient of a vial is optimally utilized, reducing the cost of Botox per unit to a minimum.
Careful Dosing at Initial Treatment
Especially when treating new patients, I initially dose cautiously. Why? Because I don’t yet know the intricacies of the face. I can only roughly estimate how the Botox will work. And I’d rather err on the side of caution, as I can always add more later. An initially excessive dose, on the other hand, can’t be corrected.
Botox in the Forehead for Migraines
Sometimes high doses of Botox in the forehead cannot be avoided. In the therapy of migraines, for example, they are provided for. A full 35 units according to the standard protocol. Therefore, the sinking of the eyebrows is considered a typical side effect. Many complain that they look as if they have tired eyes after Botox. For patients whose primary concern is the relief of their suffering, this may not be so important. However, I still try to keep the dosage low initially. Only if the effect fails, one will have to choose between two evils. And increase the dose, even risking brow ptosis.
Subtly Smoothing Forehead Wrinkles with Baby Botox
Baby Botox is another way to avoid ptosis and frozen Botox forehead. In this case, the toxin is diluted more than usual. And it’s not injected into the muscle, but only into the skin above it. The effect thus only extends to the muscle fibers that reach into the skin. The muscle itself remains largely untouched.
In this way, forehead wrinkles can be smoothed without taking on the risk of a rigid Botox forehead. And since injecting Botox into the skin also reduces sweating, reduced sweating on the forehead is often a welcome side effect.
Treatment Video Botox in the Forehead
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Muscular Basics
The muscles in your face are arranged in such a way that their forces work in opposite directions. In this way, they counterbalance each other. If you look at a face perpendicularly from the front, there are muscles that lift the facial expressions (so-called levators) and those that pull them down (depressors).
The large forehead muscle (Musculus frontalis), which causes the horizontal wrinkles of the forehead, has a levator function: it lifts the eyebrows. If you weaken it with Botox, its upward force is neutralized. Frequently, this can be exactly right and create a perfect expression.
In other cases, however, it can lead to the antagonists of the forehead muscle now being too strong. We’re talking about the depressors of the eyebrow region. Because the forehead muscle no longer counters them strongly enough, their force pulls the forehead down. The result is that the eyebrows drop, a condition known as brow ptosis.
Keep Muscles in Balance – Prevent Ptosis
Brow ptosis can have a very disadvantageous visual effect, especially in people of advanced age. In their case, tired eyes after Botox are quickly noticed. In the worst case, one eyebrow is higher than the other. This should be corrected without fail.
However, the experienced doctor ensures from the outset that the muscles of the upper third of the face remain in balance: if one is weakened, the other must also lose strength. Otherwise, the overall impression quickly becomes unbalanced.
Treating More Than Just the Forehead Muscle
In the specific case of forehead wrinkles, this means not only injecting Botox into the large forehead muscle, but also treating the eyebrows and glabella at the same time. This way, the upper third of the face remains in balance. The facial expression looks natural and sympathetic. A frozen forehead is also not a threat with a combined treatment at a relatively high dose if the doctor proceeds with caution.
No Rule Without Exception
In some cases, however, it may be advisable to do exactly the opposite. Instead, you initially treat the glabella with Botox. After two weeks, you wait for the full effect to take place. Only then do you treat the forehead. Such an approach is recommended when it is unclear how strongly the glabella’s muscle, the Musculus procerus, is involved in the formation of forehead wrinkles.
If you weaken it beforehand with Botox and then find that the forehead wrinkles have already significantly decreased, treatment of the forehead muscle may not be necessary at all. At least not with the full dose. On the contrary, the normal dose could in such a case lead to the levators of the forehead region being too strongly weakened, allowing the depressors to gain the upper hand, and the overall facial expression no longer appearing balanced.
Treatment Process
The Botox forehead treatment in my clinic in Munich follows a fixed procedure in five steps. The safety of my patients and the quality of the results always come first. And since no face is like another, I take enough time for each patient and plan the procedure individually.
Consultation
In the first step, a detailed discussion of the patient’s initial situation and aesthetic goals takes place. What is the aim of the Botox forehead treatment? Is the goal realistically achievable? What are the costs? What are the risks? If all questions are satisfactorily answered, the patient signs a consent form for the treatment and a fee agreement. Subsequent “surprises” are excluded. This step takes 15–30 minutes.
Local Anesthesia
Local anesthesia is usually not necessary for Botox in the forehead. However, if particularly pain-sensitive patients desire it, it is of course possible. Typically, I would then numb the area with a lidocaine cream. It requires an application time of 30 minutes. Therefore, if necessary, this step takes an additional 30 minutes.
Cleaning & Disinfecting
Thorough cleaning and disinfection of the forehead are essential to prevent bacterial infections. Therefore, traces of makeup and other impurities must be removed. Afterwards, I disinfect the face with a skin-friendly disinfectant. This step takes 5 minutes.
Injecting
The actual injection of Botox into the forehead is relatively quick. It only takes a few minutes. Even if the glabella and eyebrows are treated at the same time, the injections usually do not take more than 5 minutes.
Aftercare
After the injection, we both look in the mirror, do a quick check to make sure everything is okay, and the result meets the expectations – done. We will see each other for the follow-up appointment in 14 days. If any complications should occur between treatment and the follow-up appointment, we will communicate immediately. For this, you have my phone number.
How Much Does Botox for Forehead Wrinkles Cost?
As a guideline for the cost of Botox treatment for the forehead, I can mention around €290–€430 for my practice in Munich. This includes a whole vial of toxin with 50 units. This is usually enough to treat forehead wrinkles, glabella, and eyebrows in one session. If you want to have your forehead treated with micro-Botox, it is cost-effective to also treat other areas in order to fully utilize a broken vial of Botox. In this case, the benchmark for costs per unit would be around €6-€8. You can find more information on my Botox cost page.
Please note: The calculation of the Botox costs of an individual treatment follows the German Medical Fee Schedule (GOÄ). The individual price of a Botox treatment can therefore deviate from the stated benchmarks. It depends in particular on the amount of toxin used. Please also assume that the cost of Botox into the forehead will generally not be reimbursed by statutory or private health insurance.
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Frequently Asked Questions
No, unfortunately, Botox does not help with all forehead wrinkles. Good results can be expected in patients who can consciously produce and remove the horizontal wrinkles by tensing and relaxing their forehead. However, in patients where the horizontal lines are always visible due to increased muscle tone (basic tension), satisfactory results cannot be expected with Botox alone.
No. Botox does not work on sleep wrinkles. These vertically oriented lines are not caused by muscular reasons. They rather occur because the skin repeatedly and persistently bunches up when sleeping on one side.
The most common consequence of too much Botox in the forehead is drooping eyebrows. If the problem occurs asymmetrically, one eyebrow may be higher than the other. This is known as brow ptosis. It has an unfavorable visual effect. It typically resolves within a few weeks. To aid the process, the eye area can be gently massaged using fingertips or the back of an electric toothbrush. Eye drops containing apraclonidine (Iopidine 5 mg/ml) can also be considered for support.
As mentioned above, a suitable alternative to traditional Botox in the forehead is a procedure called Baby Botox. In this approach, the toxin is injected in a more diluted form into the skin rather than the muscle. Facial expressions are not affected. In cases where forehead wrinkles do not have a mimetic origin or cannot be optimally treated with Botox due to increased muscle tone, options such as hyaluronic acid injections, PDO thread lifting, or laser treatment are suitable alternatives.
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About the Author:
Dr. med. univ. Eva Maria Strobl is the owner of LIPS and SKIN Aesthetic Medicine practice in Munich. She is a trained specialist in general medicine (MedUni Vienna) and has over 10 years of specialization in non-surgical aesthetic procedures. Dr. Strobl is a member of the German Society for Aesthetic Botulinum Therapy e.V. (DGBT), the German Society of Anti-Aging Medicine e.V. (GSAAM) and of Network Global Health. She publishes regularly on her blog and on DocCheck.
