What is Botox, where should it be injected and do I need it?

Botox is a neuromodulator which de-innervates, or disables, the ability of the muscles to contract. Typically Botox is injected with a very small needle into the forehead muscles and into the muscles between the eyebrows. Botox is also often injected into the crows feet area adjacent to the lateral side of the eyes. When Botox is injected in the forehead area, it blocks the ability of the frontalis muscle from elevating the eyebrows. Sometimes patients are surprised by this because they often think that Botox is elevating their eyebrows when in fact Botox actually blocks the ability to elevate the eyebrows.

Depending on where the Botox injection stops in the lateral forehead, the eyebrows will still elevate because the muscle is not blocked from contracting in that area. Patients recognize a portion of the lateral eyebrow moving up in the area that was not injected with Botox.

It is very important to talk to your provider about what specifically you don’t like about your forehead appearance and to make sure that Botox is carefully injected. Ideally Botox will smooth the forehead and decrease pre-existing crease lines that have developed as a result of the frontalis muscle contracting. The crows feet area is very challenging to block completely because Botox is typically injected into the orbicularis oculi muscle on the outside corner of the eye, but the crows feet can still be visible as a result of cheek elevation when you animate or smile.