Botox for the Upper Face in Washington, DC
The first uses of Botox and related neuromodulators such as Dysport were for the treatment and prevention of lines and wrinkles of the upper face. Botox temporarily reduces the activity of and relaxes certain muscles of facial expression, leading to smoother skin in these regions, a more relaxed and refreshed look, and slowing or stopping the development of fixed lines and wrinkles of these areas. When properly administered by skilled master injectors, neuromodulator treatment with Botox deliver natural appearing results without a ‘frozen face’ appearance. The three popular treatment areas of the upper face are the frown lines or ’11’s’ (Glabellar Region), horizontal forehead lines (frontalis muscle), and crow’s feet (orbicularis muscle).
Botox Treatment of Frown Lines / 11’s
Treatment of the glabellar region, which is responsible for the formation of frown lines, also referred to as ’11’s’, involves injection of Botox directly into 2 muscle groups. The first is the procerus, a muscle between the eyes whose action is the pull down on the brow and central eyebrows, creating horizontal lines at the base of the nose between the eyes. A single injection point is typically used to treat the procerus muscle. The second muscle group is the corrugator muscles, which lie above the central eyelids and pull centrally, furrowing the brow and creating the vertical lines between the brows when frowning. Typically 2 injection points per corrugator (R&L) are used to treat this muscle group. The net effect of treatment of these two muscle groups is a reduced frown line activity as well as a medial brow lift, resulting is a softer, more refreshed look to the region.
Botox Treatment of Forehead Lines
Horizontal wrinkles of the forehead are due to contraction of the frontalis muscles, a thin sheet like muscle spread across the forehead. Its action is both a brow elevator (raises the brow) as well as a scalp depressor (pulls the frontal scalp down). Contraction of the frontalis muscle results in wrinkling of the forehead and development of dynamic wrinkles of expression of the brow. As the dynamic wrinkles occur in the same places with each contraction, over time repeated contraction can lead to static wrinkles of the forehead, which are lines present at rest. With proper injection technique, Botox treatment of this area can soften the wrinkles associated with frontalis contraction, leading to a smoother, softer appearance of the skin of the forehead. Additionally, with proper treatment technique, both the lower forehead and upper forehead can be treated, leading to a neutral effect of brow elevation and no feeling of ‘heavy brow’ associated with improper injection technique. The forehead is also a very popular treatment area for ‘baby botox’ where smaller quantities of Botox are used to soften lines of expression, preventing development of lines and furrows.
Botox Treatment of Crow’s Feet
Botox treatment of crow’s feet involves injection into the muscle lateral to the eye. Contraction of this muscle, the orbicularis, results in horizontal wrinkling of skin and squinting of the eyes when smiling. Treatment of the crow’s feet involves carefully placed injections into the muscle to the side of and often extending below the eye onto the upper cheek. The resulting effect of this injection is a relaxation of this muscle, leading to reduction in horizontal lines emanating from the lateral eyes during smiling and squinting, as well as a lifting effect to the lateral eyebrow. Proper injection technique is important when treating the crows feet, as inadvertent injection into the strap muscles of the face can lead to an asymmetric smile.
Botox Brow Lift
The Botox Brow lift utilizes combination treatment of the Glabellar Region and Crows Feet region to relax the muscles which create downward tension on the eyebrows, resulting in elevation of the brow at rest and during expressions such as smiling. While many people believe that the brow lift involves treatment of the forehead, as the frontalis muscle of the forehead is the muscle which elevates the brow upon contraction, treatment of the forehead does not result in brow elevation of any sort. A favorite among patients, the Botox brow lift results is a refreshed, more rested look to the face at rest and during expression.
