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Why Do Vertical Lines Appear on the Forehead After Botox?

Vertical forehead lines are typically formed over time due to side sleeping, in which the skin is compacted from one side, causing rippling across the forehead muscle for 6 to 8 hours per bedtime. Botulinum toxin injection is the most common cosmetic procedure for these vertical lines. However, this 11-like wrinkle that forms between the brow may be treated by a dermal filler.

So why are there vertical lines on forehead after Botox? Botox injection is a muscle relaxant. The outcomes are defined by soothing the injected muscle fibers. The appearance of vertical lines after Botox is due to its unique utilization and weaving. The corrugator muscle is responsible for creating the inter-brow number “11” creases. Once these muscles are crippled, the brain recruits the orbicularis oculi to produce the same expression.

Say Goodbye To Your Wrinkles and Fine Lines

With just a few simple injections, our providers can erase your wrinkles and fine lines in no time with Botox. Call us today to book your appointment.

How Does Botox Injection Work on Forehead Lines?

Botox cosmetic injections are the most widely used treatments in the world. The fascination with Botox has increased considerably over the last ten years as its prominence has grown. Many people ask questions about what cosmetic Botox is, how it works, and so on. 

In addition, they also want to know the reasons why patients see vertical wrinkles after a Botox treatment. Botulinum toxin treatment is a purified protein that’s utilized to treat wrinkles caused by a facial expression. Once Botox is injected into the skin, it relaxes the muscles and smoothes out the static wrinkles.

The Botox treatment is commonly administered to the upper face. These include horizontal forehead wrinkles seen on the upper forehead when raising the brow, vertical lines seen between the eyebrows when frowning (frown lines), and crow’s feet that appear around the eyes when smiling. 

Once patients introduce their issues about particular forehead wrinkles, such as frown lines, it’s critical to evaluate and address the other upper-face wrinkles, like horizontal forehead wrinkles and crow’s feet. The possible explanation for this is to keep the upper face in a natural and harmonious balance.

When a person frowns, the muscles in between brows (glabella), which are responsible for the appearance of the glabellar lines, pull down on the inner brows. Consequently, the muscles around the eyes that induce the crow’s feet seen when smiling (orbicularis oculi) are also liable for dragging down on the brow, but only the outer brow. 

The muscle in the upper forehead (frontalis muscle) that’s responsible for the horizontal forehead wrinkles when raising the eyebrow, on the other hand, helps pull the eyebrow upward. If the frontalis muscle is injected with Botox while the others are not, the other muscles will remain active.

As a result, the frontalis muscle will be unbalanced and unnatural. It will appear as if the brow is lifted, depressed, or irregular in position or shape. Therefore, experts advise patients to take a holistic approach to the upper face when getting a Botox treatment and treat all three areas. Bunny lines on the nose bridge are sometimes treated as well.

Learn More: How many Units of Botox Should be Used on The Forehead?

Understanding Wrinkles and Vertical Lines

Genetic factors (aging skin, deficit of elasticity and firmness, weaker cell renewal rate), hormonal fluctuation, exposure to sunlight, smoking, pollution, stress, and of course, repeated movement in the underlying facial muscles all contribute to the appearance of vertical lines and dynamic wrinkles. Horizontal forehead lines are typically the first to appear. 

They appear in the corners of the eyes (crows feet) and on the eyebrow. The deeper, more noticeable large wrinkles and a vertical forehead wrinkle are due to recurring muscle contraction and facial expression. Some argue that they fully reflect the essence of a human’s personality.

The muscle tissue and facial skin become slack over time, nearly losing their capacity to return to their original position. Then, the muscles mimic our natural, unconscious facial muscle movement. Experts took the effort to create original names for such lines, perhaps to make them more acceptable. Here are the most common types:

Marionette expressions or a sad smile. Such facial lines, as the name implies, drive straight down from the mouth’s corner to the lower jawline. This facial wrinkle resembles the enunciated mouth of a ventriloquist’s puppet when they’re very pronounced.

Smile lines or nasolabial folds. These fine lines extend from the nostrils to the mouth’s corners. Having them isn’t entirely bad because it implies we’ve smiled a lot through the years. 

Frown line. This well-known line appears on the space between the eyebrows called glabellar lines. It’s correlated with frowning, as the name implies. Glabellar lines on the brow can give people the impression that they’re angry, anxious, suspicious, or in deep thought. On a brighter note, Asians believe they’re a sign of a female’s persona.

Possible Adverse Effects of Botox

Botulinum toxin injection appears as the most valid alternative for many people with forehead lines and small wrinkles due to its effectiveness and faster recuperation period. However, adverse effects are still possible. Although more significant problems are uncommon, they should still be discussed with a healthcare provider ahead of time.

It also implies that people may not simply go to a Botox party for an injection. It may not have protections in place to guarantee safe and effective treatments. Generally speaking, Dermatologic Surgery reports that most patients who use Botox for their facial wrinkles experience mild to moderate adverse effects.

Patients may notice some swelling and redness around the eyes after leaving the healthcare provider’s clinic. It’s also possible to get minor bruises. Such side effects can occur if the doctor injected Botox into the muscles around the eyes. There should be no pervasive inflammation. 

Other potential risks are as follows:

  • aridity (especially around the injection site)
  • crooked eyebrow
  • excessive tearing
  • headaches
  • brow ptosis

Seek immediate medical attention when experiencing any of the following uncommon but severe side effects:

  • issues consuming food and beverages
  • vision and speech impediment
  • breathing difficulties
  • bladder control problems
  • weak muscles that begin in the face and spread throughout the body

For best Botox injection results, it’s necessary to commit to it. Other injections with similar effects are also accessible, such as Myobloc, Dysport, and Xeomin. These medications, however, cannot be used interchangeably because their strengths and dosages vary.

Learn More: Side Effects of Botox on Forehead

Some Alternatives for Forehead Lines

There are several products available to smoothen and soften the presence of forehead lines. There are some home treatments that you could consider.

Hyaluronic acid

It has been shown to fill invisible gaps in the skin barrier, smoothing it out. It also plumps the skin after it has been absorbed. According to many studies, hyaluronic acid can substantially reduce the occurrence of wrinkles over time.


Peptides in skin serums, cleansers, and creams can brighten the skin and enhance cell turnover. While this won’t eliminate wrinkles, it will make the skin look smoother overall by preventing the facial muscles from twitching and contracting as they usually would. 

Clinical studies suggest peptide products can help boost collagen production in the skin and enhance the skin’s sensitivity to strains caused by everyday activities.

Antioxidant creams

Antioxidant skincare products can assist the skin in combating the damage caused by oxidative stress. The natural outcome of exposure to toxins and air pollution in the environment is called oxidative stress. 

Antioxidant-rich skin creams, such as green tea extract and vitamin E, may stimulate facial rejuvenation and make the skin texture younger looking. Remember that the heavy cream consistency may be excessive for several skin types. 


To keep the skin hydrated, dermatologists highly suggest moisturizing overnight creams and a daily hydrating regimen. Skin that has been properly hydrated is more resilient and holds its shape better with time. 

When at-home remedies don’t sufficiently ease the forehead furrows, consult a dermatologist about medical procedures. The following suggestions may help to conceal the forehead creases.


A facelift is the most expensive and risky procedure to smooth forehead lines. Facelifts are cosmetic procedures that tighten the skin on the neck and face. When these surgeries are successful, they produce long-term results. Moreover, it’s difficult to predict how the patient looks after the facelift.

Other possible drawbacks to remember are:

  • Facelifts are costly in contrast to other treatments.
  • Facelifts necessitate many weeks of the healing period.
  • There’s a high risk of infection with facelifts and brow lift surgery.
  • It’s possible that the wrinkles will reappear over time.

Juvederm and other dermal fillers

Soft tissue dermal fillers are designed to mimic collagen and other systemic skin components. Among the product lines in this section are:

  • Juvederm
  • Sculptra
  • Restylane

Botox injection and dermal filler have some significant distinctions, but both have a low risk of side effects. Dermal fillers do have the potential for side effects, and they can be more expensive than Botox. 

Book a Consultation and Learn More About Excessive Facial Wrinkles Treatment at aNu Aesthetics™

woman on consultation with professional botox provider

aNu Aesthetics and Optimal Wellness offers a wide range of medspa and wellness experiences. We believe that beauty comes from within, which is why we offer an unrivaled variety of beauty and wellness therapies. Dr. Cristyn Watkins founded aNu Aesthetics and Optimal Wellness. Since 2006, she has earned an excellent public image in the community as an advanced physician. Dr. Watkins is a family and functional medicine physician. She’s also an accredited master injector and a national Regenerative Medicine instructor. 

Your whole well-being is essential to the overall quality of life. aNu Aesthetics and Optimal Wellness recognizes that not all aches, pain, and conditions are easily detected or diagnosed. That’s why we offer various non-surgical procedures and service therapies that improve your general health and overall wellness. You can select from our most cutting-edge services available today and feel the benefits in the body right away without undergoing cosmetic surgery. Reach out to us today to get a free consultation or schedule an appointment.

Say Goodbye To Your Wrinkles and Fine Lines

With just a few simple injections, our providers can erase your wrinkles and fine lines in no time with Botox. Call us today to book your appointment.

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