Why do we treat the Glabella/Frown Lines with Botulinum toxin?

One of the most common cosmetic Botulinum toxin treatments is the Frown lines in the upper face, these lines are created by the muscles in the Glabellar complex, the Vertical 11 lines between the brows are created by over repetitive movement of the 2 Corrugator muscles and the Horizontal line at the bridge of the nose is created by the Procerus muscle. These 3 muscles represent the strongest depressor muscles of the upper face.

Patients most often seek treatment because they believe these lines make them look angry, cross or unapproachable even when they are not.

There are several different Toxin injection technique approaches for the Frown lines.

1 - The licensed/on label technique and dose

The licensed/ on label technique and dose can be found on the Botulinum Toxin SmPC sheet and is recommended by the Toxins manufacturers, in the case of the brand Botox® this would be Allergan.

The licenced/on label patterns are designed to give acceptable results to the greatest proportion of patients treated, however they are less effective at treating anyone with atypical anatomy. For Botox the on-label pattern and dose is 5 x 4-units injection points, one into the Procerus and two into each Corrugator.

2 - The 7-point Glabellar

This technique is a more tailored approach for patients who want no movement in the frown complex/brow furrows or for patients who have longer Corrugators, the last 4-unit injection point in the medial Corrugator can be broken up into 2 points, a 3 and a 1-unit dose. The 7 points are 1x 4-units injected into the Procerus, 1x 4-units injected into the head of each Corrugator (the origin of the muscle), followed by 1 x 3-units injected at an intermediate point into the body of the Corrugator, and lastly a 1x 1-unit injection into the insertion point of the muscle, where the last fibres of Corrugator insert into the skin of the brow.

This approach is often a more favoured approach as the patient achieves a no movement result reducing the need for a review or ‘top up’ treatment.

3 -The 3-point Glabellar

This approach involves fewer injections points and leaves some movement.

The 3 injection points are – 1 into the Procerus 1 x 4-units, 1 injection point into the head of the Corrugator on either side, this can be 4-units or a little more. This technique approach leaves remnant lateral movement in the Corrugator muscle and can be suited to patients who want some frown expression to remain. This technique also requires a lesser unit dose amount.

At Cosmed Academy we offer Foundation and Advanced Botulinum toxin courses – Courses can be booked at www.cosmed.ie