Botulinum toxin treatments have become the most sought after cosmetic procedure in aesthetic medicine. Though the extremely popular procedure can result in a more youthful appearance, adverse events can occur, the most common of which are brow and eyelid ptosis.

One of the main challenges when treating the upper-third of the face with botulinum toxin is how to treat the frontalis muscle in the forehead appropriately to smooth out wrinkle lines without creating a dropping of the brows.

"Correctly treating the frontalis muscle can be challenging. If injections are placed too low in the lower half of the muscle, you have a greater chance of brow ptosis," says Ronald Moy, MD, president of the American Academy of Dermatology and professor at the David Geffen School of Medicine at the University of California, Los Angeles. "Physicians with less experience may often make the mistake of injecting too low, resulting in a dropping of the brow."

According to Moy, one simple way to avoid this adverse event is to treat the upper half of the forehead/upper half of the frontalis muscle. Over time, the muscle will atrophy, weaken and drop due to the effects of gravity, particularly in patients over age 50.


[Source: Cosmetic Surgery Times/Modern Medicine]