I do tons of botox injections. I have seen botox do browlifts (raise the eyebrow position) when I inject it around the eye into the orbicularis oculi muscle. So when I first saw this journal article, I almost skipped it. But then I read they injected botox into the HAIR BEARING scalp skin, and I thought, hmm. Something different! So I read on.
Aesthetic Surgery Journal March 2018. “Forehead lift using Botulinim Toxin.” It was a study out of Israel on 29 patients, average age 48. The later age intrigued me. This age is harder because it is around when injecting the forehead starts to get tricky- many people need eyelid surgery near this point, so injecting the forehead muscle (called the frontalis) can cause the forehead to drop, which makes the skin around the eye droop.
Study:
- Inject 40 units of Dysport into 4 points in the hair bearing scalp near the point of the frontalis origin (where the frontalis muscle hits the galea occipitial muscles) NOTE: these are units for Dysport- NOT BOTOX brand botox.
- Glabella (the “11” from the corrugator muscle) got 50 units.
- Frontalis (the forehead muscle) got 50 units
- Photographs were taken before and after at 2 weeks
- Forehead height was measured at midpupil line to frontal hairline
- They looked at differences for those with low foreheads vs. high foreheads
- NOTE: at their dilution, 50 units of Dypsort is equal to 20 units of botox. They did 10 units Dysport into each scalp injection
Results:
- Mean age 48
- 2 weeks after treatment, mean frontal height increased significantly in all measurement points. (average 4-4.7mm)
- Low forehead group had significantly higher forehead lift (6.9 vs 5.3, and 8.6 vs 5.7)
Thoughts?
WOW!
I love what botox does, and I hate it when people get to a point where I have to stop injecting their forehead wrinkles because it drops their brow. These plastic surgeons have shown how to counter that, by injecting up in the anterior hairline they are truly raising the forehead. They inject at the hairline at the medial canthal line and at the mid pupil line on both sides of the scalp. The only negative I see is in those with a high hairline already, as I can see in the photos it causes the hairline to recede a little. But for those with a low hairline, this is absolutely something to consider. I will absolutely be including this in my toolbox of tricks.