Article medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)
Templestowe Lower and Berwick Clinics
Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
Updated 29 June 2020
Quick Facts about forehead wrinkle treatment
- Wrinkles from the contraction of the forehead muscle can be addressed with anti-wrinkle injections. Care needs to be taken not to cause drooping of the brow or upper eyelid.
- Volume replacement of the forehead with dermal fillers helps to balance the face as well as smooth forehead concavities and wrinkling.
- Sun-damaged skin can be treated with medical-grade skincare and lasers.
- Skin laxity is best treated with surgical methods.
Forehead wrinkle treatments
Wrinkling of the forehead is a common concern of both men and women. The underlying mechanism causing wrinkling is contraction of the frontalis muscle. This muscle is responsible for lifting the brows, is a muscle of facial expression, and on contraction causes parallel horizontal lines on the forehead. Raising the eyebrows, together or separately, can portray a myriad of different emotions.
The frontalis muscle is activated to help lift the brow and upper eyelid to improve the field of vision, that is, it ‘opens the eyes’. Therefore, it is particularly active in those who have an excess of skin on their upper eyelids that causes partial occlusion of the visual field. When upper eyelid skin causes a significant reduction in the visual field, it is possible that the frontalis muscle can become constantly activated (contracted) in order to lift the brows / eyelids to keep the eyes more open. The more active the frontalis muscle, the more significant the presence of horizontal lines in the forehead.
Forehead wrinkle treatment often is a compromise between moderating the activity or contraction of the frontalis muscle using anti-wrinkle injections (which reduce the contraction of the muscle), and preserving the elevating power of the frontalis muscle. Anti-wrinkle injections reduce the contraction of the frontalis muscle by preventing the transmission of the nerve signal to the muscle, and are temporary in nature, lasting from 2 to 4 months on average. Treatment involves several fine injections into the frontalis muscle, and onset of action is from 4 to 7 days, depending on the type of anti-wrinkle injection used. The dose that is used needs to reduce forehead movement enough to reduce the severity of forehead wrinkling, with consideration to keeping some of the function of the muscle in elevating the brows. In those who have heavy upper eyelids, and constant compensatory contraction of their frontalis muscle, anti-wrinkle injections cause decompensation of this mechanism that holds their eyelids/eyebrows up, and even small doses may cause a sense of heaviness in the brow/upper eyelids. Practitioner assessment of the pre-treatment state of the brows and upper eyelids is therefore important in determining the dose to be used.
In addition to the dosage, the location of the injection points of anti-wrinkle injections in the forehead are an important consideration in achieving ideal aesthetic outcomes. Often patients will request a brow lift in addition to a reduction of forehead lines. This can be achieved by treating the central parts of the forehead only, and leaving the areas above the tail of the eyebrows. However, this can cause an unnatural arch in the brows, as well as leaving wrinkles that are located just above the tail of the eyebrows. A more appropriate method of treating the forehead is to inject the forehead more uniformly. Taller foreheads may require more injection points to attain a more even result.
It is important to understand that anti-wrinkle injections only reduce dynamic forehead lines. That is, they only reduce the lines that occur with movement. If lines appear whilst the forehead is at rest and not moving, anti-wrinkle injections will not improve these lines.
Forehead volume loss
The forehead tends to lose volume with ageing due to loss of subcutaneous fat, bone resorption, as well as thinnning of the muscles and skin. This causes flattening or concavities to form in the forehead and the bony outline of the skull to become more evident. Furthermore, the loss of volume can tend to increase the propensity of the skin to wrinkle with contraction of frontalis (forehead muscle).
Replacement of lost volume is best achieved by using dermal fillers or fat transfer. These can be strategically placed to improve volume of the forehead, and to recreate a more convex and youthful appearance. Revolumisation provides resistance to skin creasing, and brow support.
It is a common oversight by both patients and practitioners to not recognise forehead and upper face volume loss. The concern is often disguised by hair, or the focus is on other parts of the face. Replacement of volume in the forehead not only rejuvenates the face, but also in many cases improves the overall harmony and balance of the area, and general smoothness of the forehead.
This patient presented to Victorian Cosmetic Institute with concerns of the way her frown lines made her appear. She is a happy and joyful person and wanted her face to reflect her kind nature. The results is a youthful and natural appearance with no surgery. The static lines have been smoothed using dermal filler and reduced the cause of her frown lines with anti-wrinkle injections.
Forehead skin and sun damage
The forehead is one of the first places on the face to be exposed to the sun, and often prone to skin changes such as freckling, sun spots, and solar damage or skin cancers. Those with fairer skins are at higher risk of solar damage, and need to be particular about sun protection with sunscreen, hats, and excessive sun exposure.
Lasers are the next step, and can improve problems such as brown spots or pigmentation more effectively than skin care alone. Lasers such as the Fraxel laser or Ruby laser are very effective in the removal of brown spots. For static wrinkles, or wrinkles that are etched into the skin, often skin resurfacing using a carbon dioxide laser such as the Lumenis Ultrapulse laser can be performed, however, significant downtime is often required.
Forehead droop / brow position
The forehead is one of the first places to sag in the ageing process. This leads to heavy brows and upper eyelids.
Although there are non-surgical methods of treating this concern, such as with skin tightening devices such as the Pelleve, we find that surgery provides significantly more dramatic results.
Surgical brow lifts can help to improve the position of the brow, and improve the skin firmness and quality of the forehead.
Why choose the Victorian Cosmetic Institute?
Our doctors have many years of specialist experience in the use of anti-wrinkle injections, dermal fillers and lasers for the treatment of your concerns. We allow you ample time to communicate your aesthetic goals to us and use our expertise to help you achieve your desired outcome.
To book an appointment please call 1300 863 824 or click on the ‘Book Online’ button.