MilfordMD Cosmetic Surgeon Dr. Richard E. Buckley Argues Why RealSelf’s “Most Worth It” Treatment Shouldn’t Always be the Go-To for Forehead Wrinkles

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Botox has been one of the gold standards for erasing facial lines and wrinkles caused by muscle movement and the go-to treatment people request when wrinkles start developing on the face. Dr. Richard E. Buckley, Medical Director at MilfordMD Cosmetic Dermatology Surgery & Laser Center, in Milford, Penn reveals one reason it’s not always the best option for forehead wrinkles.

Dr. Richard E. Buckley explains when not to get Botox injections for forehead wrinkles

Dr. Richard E. Buckley shares when Botox isn't the best option for addressing forehead wrinkles and why it’s important to choose an injector who knows to look for this subtle difference.

As the gold standard for wrinkles, Botox is the most popular aesthetic procedure, but it’s not always the best option when it comes to forehead wrinkles because it doesn't address the root cause, and in fact, may worsen the overall appearance.

Approved by the FDA for cosmetic use in 2002, Botox has become one of the gold standards for treating crow’s feet, frown lines, and forehead lines and one of the world’s most recognized and iconic brands. It has been the number one aesthetic procedure performed by plastic and cosmetic surgeons since 1999 and in 2020 it is again among’s Most Worth It treatments. It’s extremely popular among millennials who want to proactively treat the signs of aging and remains the most researched non-surgical cosmetic treatment. While Botox’s main use is treating moderate to severe frown lines in adults, Dr. Richard E. Buckley, cosmetic surgeon and Medical Director at MilfordMD Cosmetic Dermatology Surgery & Laser Center, in Milford, Penn., reveals when Botox isn’t the optimal choice for treating forehead wrinkles.

“For a lot of people, at the first sign of facial wrinkles and lines, they start to think about Botox,” says cosmetic surgeon Dr. Richard E. Buckley. “Botox and other neuromodulators, such as Dysport, Xeomin, and Jeuveau, are a great options for treating facial wrinkles caused by repetitive expression leaving its mark on the face. Neuromodulators relax overactive muscles resulting in smoother and more youthful looking skin. In most cases, when a patient wants to address facial wrinkling, Botox is a good option. But, for some patients, when they come in wanting a relaxer like Botox to treat forehead wrinkles it’s not the right option. It’s not the right treatment option because what they have is not simply wrinkles because of expressive movement but rather they have volume loss and stretched lax skin.”

Botox works by targeting an underlying cause of wrinkles – the repeated muscle contractions from facial expressions over the years. Repeated facial movements, such as raising eyebrows cause wrinkles, such as forehead lines to develop. When injected into the muscles, Botox temporarily reduces muscle activity and creates a smoothing effect of the wrinkles and lines.

“Some forehead wrinkles are simply due to repeated expressive facial movement and some are a combination of repeated expressive facial movement plus sagging in the skin on the forehead causing a lowering of the brow and eyebrows. When this happens, the eyebrows are lower and since they are lower the skin of the upper eyelid is accordioned together making it look like there is a bunch of extra eyelid skin. It can droop so low that it is cutting down on the amount of light that gets into the eye thus impairing vision,” states Dr. Buckley.

The last thing you want to do for someone with forehead wrinkles and sagging is inject Botox into the forehead wrinkles, according to Dr. Buckley. Once injected into the forehead muscle, the frontalis, the muscle relaxes which would make the eyebrows droop even lower. “Injecting Botox in this case might improve the forehead wrinkles but it’s also going to lower the eyebrows which are already low to begin with,” says Dr. Buckley. “In this case, since the forehead also likely has lost volume, it’s important to restore volume in the area with a hyaluronic acid dermal filler such as Restylane or Juvederm. Putting volume in the forehead and right underneath the eyebrows restores the lost volume and raises the eyebrows. Elevating the eyebrows results in a more open and refreshed looking appearance. Then Botox can be used to smooth out additional wrinkles in the forehead. This combination produces a smoother complexion and more youthful appearance.” If the amount of forehead skin sagging is significant then a surgical brow lift procedure would be a better option.

In a recent Miami Herald article, a patient mentioned that after getting Botox in the forehead her forehead dropped and the mid-part of her eyebrows were noted to have fallen. “When a patient is experiencing these types of results it’s not the Botox as much as the injector,” says Dr. Buckley. “Botox has become so popular that everyone wants to cash in on the popularity including people who are not trained in facial anatomy or aging. This is why it is imperative that you choose a cosmetic physician surgeon who understands facial anatomy, the effects of aging and who can tell when forehead wrinkles are due to repeated expressive movements and when they are a result of facial sagging.”

About MilfordMD Cosmetic Dermatology Surgery & Laser Center:

The MilfordMD Cosmetic Dermatology Surgery & Laser Center offers state-of-the-art highly specialized procedures in laser and cosmetic surgery and aesthetic skin care. In addition to its AAAHC nationally accredited surgical center and extensive laser surgery capabilities, MilfordMD offers physician designed skin care products for home use. Milford Pennsylvania’s MilfordMD Cosmetic Dermatology Surgery & Laser Center is sought out by patients from around the world for expertise and innovation in cosmetic treatments performed by Board Certified Physicians, Richard E. Buckley, M.D. and Marina Buckley, M.D.

MilfordMD Cosmetic Dermatology Surgery & Laser Center is located at 303 W. Harford Street, Milford, PA 18337. Tel: (570) 491-1962. For real patient video testimonials, follow MilfordMD on Instagram and Facebook, and visit our MilfordMD YouTube channel.

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