The use of Botox is only FDA-approved for treating glabellar lines, also known as the 11 lines, between the eyebrows. It is not illegal to use it in other areas, though, such as in the forehead and facial areas that are prone to dynamic expression lines. Physicians may use it off-label to treat other areas, as long as they are trained and licensed to inject botulinum neurotoxin. Patients who seek treatment for the horizontal lines in their forehead would often ask for additional injections in their glabellar lines.
The broad muscle that extends above the brows to the hairline is called the frontalis muscle. It is the muscle responsible in elevating the brows. A skilled physician must adjust his or her technique to suit the patient’s anatomy and goals. People may have a slightly different contraction of their frontalis. That’s why wrinkles in this area may look different from person to person.
How Many Units of Botox are Needed for Forehead Wrinkles?
There is no standard dosage of Botox for forehead wrinkles because each patient will have different needs. Some may need less amount in the middle area, and others may need equal distribution across the entire forehead. An overdosage must be avoided because without the action of the frontalis, the constant pull of the three depressor muscles will cause the brow area to sag. Aside from looking flat, it could make the upper eyelids look heavy. Keeping the whole forehead wrinkle-free can also increase the length of the forehead.
The average doses for frontalis injection are as follows:
- WOMEN – 10 to 30 units
- MEN – 20 to 40 units
If a patient also seeks treatment for the glabella, injectors may treat the glabella first and have the patient follow up after 2 weeks, so that lower dosages can be used in the forehead. Wider foreheads may require more injection to cover the whole area. Higher doses are known to provide longer duration and efficacy for forehead wrinkles.