Smoothing the frown line with Botox

Treatment of frown line

When the frown line is disturbing

The frown line is often very disturbing, but can be treated well with Botox. This is because it has nothing to do with anger, of course. Rather, it is caused by prolonged, strained vision. More precisely: by the associated tension of the muscles. The main reason for the frown line is the constant pulling of the mimic muscles between the eyes. But why is the frown line called that? Because in many people, primarily men, it looks grim. Often so strongly that it stresses those affected. For good reason, they then ask themselves what they can do about their frown line.

Botox in the frown line

And my answer is: Botox! Botox is an ideal way to treat the frown line. At least in most cases. True, there are other methods to treat frown lines. But using Botox to smooth out frown lines and foreheads usually provides optimal results. At the same time, smoothing the frown line has little to do with the urge for “youthfulness”. But more with the desire for a positive charisma. With Botox, this desire can be realized quite easily. And in this article I will explain how.

These are the topics:

  • Causes of frown line
  • Negative emotional signals
  • Basics and procedure of treatment
  • Botox in the frown line – cost
  • Botox into the frown line – alternatives

Causes of frown line

Vertical lines in the glabella

The term “frown line” is used to describe clearly visible wrinkles in the Glabella. The glabella is the area of the forehead located between the eyes at the upper base of the nose. The tension of the glabella causes the frown line. Usually in the form of two vertical lines. The glabella is under tension during concentrated vision. At a young age, when the skin is still elastic, the frown line is usually barely visible. But as we age, it becomes more and more prominent. And it does so permanently. An frown line that digs deep into the forehead often has a negative emotional effect. Especially in men. But even in women, an frown line disturbs a harmonious overall appearance if it is too prominent.

Computer work promotes the frown line

The frown line is also a sign of the modern age. In many people the muscles of the glabella are hypertrophied. This means that they are overdeveloped. As a result, the frown line is very pronounced. The reason for this lies in the accumulation and duration of concentrated vision, which the modern working world brings with it. Especially the long work in front of the computer is to be mentioned. But also reading from early childhood. Strained vision leads to an involuntary attempt to draw the brows protectively in front of the eyes. The frown line is therefore actually a “concentration line”.

Negative emotional signals

A case from practice

As mentioned at the beginning, a strong frown line is often accompanied by negative appearance. Especially in men. One of my first Botox patients was such a man. He was in his mid-40s at the time, his appearance bulky and strong. His face was masculine and visually appealing in itself. Between his brows, however, stood a thick furrow. It was evidence of long hours in the office. In front of the computer. Even in a relaxed state it was clearly visible. It made him look unfriendly, uninviting. Even his laugh had something grim about it. And the patient suffered greatly from it.

All the more so because he had been without a job for months. He applied a lot. He also had invitations to interviews. But always only rejections. He was eloquent. Professionally qualified. “After 100 applications and 20 interviews, only rejections,” he lamented to me. He had already tried everything possible. He even started reading books on body language. But to no avail. What could it be?

Anger wrinkle as a career killer

I only had to describe my own impressions to him and he understood that his appearance could be the reason. After a brief examination, I advised him to treat his frown line and forehead with Botox. In one session. It had occurred to him before to have his frown lines smoothed out. But so far he had refrained from it out of fear.

Two sessions were necessary after all. And altogether a much higher dose than usual to weaken the strong pull on his glabella. But the result was impressive: His expression seemed relaxed again. His gaze friendly and inviting. And it may be a coincidence, but a few weeks later it also worked in the job search.

Basics and course of treatment

Frown line individually different

The frown line can vary greatly in appearance. Indeed, it depends on several factors, including gender, age, or ethnicity. Differences in anatomy and typical facial expressions create muscular patterns that vary from person to person. In people with concentrated gaze, these patterns are clearly readable. On the one hand, they create a variable visual impression. Some patterns are more disturbing than others. On the other hand, they play a major role in therapy with Botox.

Recent studies suggest that five forms are typical for the frown line are typical. I present them below, with the respective injection points for Botox marked in white:

  1. The “U” shape: the standard case with 2 vertical, central lines. Botox injections are performed according to the standard scheme.

    U shape frown line

  2. The “V” shape: Lines and bulges at the edges of the M. Procerus. Botox is injected along an elongated “V”, usually with 2 additional injection points.

    Frown line in V-shape
    Frown line in V shape

  3. The “Omega” shape: similar to a V-shape, often recognizable as an indistinct omega. The transition to the treatment of forehead wrinkles is fluid here.

    Frown line in omega shape
    Frown line in omega shape

  4. The “Inverted Omega” shape: strong downward muscular traction relocates the injection points deep into the base of the nose.

    Frown line in inverted omega shape
    Frown line inverted omega shape

  5. The “converging arrows” shape: a variation of the U-shape with only weak downward traction. The central injection into the procerus muscle can often be omitted.

    Frown line in the form of converging arrows.
    Wrath fold in the form of converging arrows

Muscles involved in the formation of the frown line

The shape of the frown line varies because several muscles are involved in its formation. The M. corrugator supercilii, the M. procerus, and the M. depressor supercilii are primarily responsible. Their roles in detail:

M. corrugator supercilii

The muscle known in German as “Stirnrunzler”, lies above the eyebrows. It has the shape of a narrow muscle band. When tensed, it pulls the brows down and inward. It also wrinkles the forehead. At the frown line he puts the vertical parts.M. corrugator supercilii and its role in the formation of the frown line.

M. Procerus

The procerus (German: “slender muscle”) lies between the brows above the root of the nose. It extends into the forehead, where its fibers cross with those of the frontalis (“forehead”) muscle. The procerus muscle pulls the skin between the brows downward. It thus contributes the horizontal parts to the frown line.

M. procerus and its role in the formation of the frown line.

Course of treatment

It takes only 20-30 minutes to inject Botox into the frown line. As shown above, Botox is injected into the glabella at 4-6 points. Four units at a time, so in total about half an ampoule is used. The dose can be lower or higher depending on the findings. If the muscles are weak, ten units are often sufficient. For men with strong muscles, up to 50 units are also conceivable. Anesthesia is not necessary. The needles I use are so thin that the punctures hardly cause any pain.

Beware of brow ptosis!

When using Botox in this sensitive area, it is important to maintain a natural and fresh-looking position of the brows. Above all, a drooping of the brows (Ptosis) must be avoided. The Botox must therefore not be injected too close to the brows. In addition, the dose must be chosen carefully.

Is every frown line treatable with Botox?

Unfortunately, no. Optimal results can only be expected in patients who can cause them when they are tense and make them disappear when they relax. On the other hand, in patients in whom the frown line is always visible, Botox alone cannot be expected to produce a convincing result. In their case, injections with hyaluron are indicated. Or a lifting with PDO threads.

Botox frown line – cost

What costs can be expected for Botox in the frown line? In my practice, the guideline is about 280 €. The concrete calculation follows, as always, the medical fee schedule (GOÄ). I recommend that my patients have the glabella, forehead and eyebrows treated all at once. One ampoule of toxin is usually sufficient for this. In terms of price, this is then cheaper than separate treatments. A hint: Please assume that costs for Botox in the frown line are not reimbursed by insurance companies.

Botox frown line – alternatives

Usually, perfect results are possible with Botox. However, sometimes they are not. For such cases, there are other techniques to smooth the frown line. One can mention injections with hyaluron as well as lifting with PDO threads. I practice both procedures with good results for frown lines. Their price is about 200-300 € more expensive than Botox. The thread lifting of the forehead is, according to my observation, strongly on the rise. The procedure is simple and is performed under local anesthesia.