Which lines does upper-face Botox treat?
The main targets are horizontal forehead lines that appear when you raise your brows, vertical frown lines between the brows and crow’s feet at the corners of the eyes when you smile. These lines are formed by repeated movement of the expression muscles.
Forehead lines are created by the frontalis muscle lifting the brows; frown lines by the corrugator and procerus muscles drawing the brows together; and crow’s feet by the orbicularis oculi muscle around the eye. When botulinum toxin temporarily reduces the movement of these muscles, the lines formed by expression soften. Fine lines that are visible at rest may also become less noticeable over time.
The three areas can be planned individually or together, and the balance between them matters. For example, relaxing only the forehead can leave some people with a heavy feeling in the brows. That is why brow position, eyelid structure and your habitual expressions are all assessed together. Which areas are treated and how the dose is distributed are agreed at a face-to-face consultation, usually starting conservatively.
What can upper-face Botox not do?
Botox does not add volume, lift hooded eyelids or, on its own, erase deeply etched lines that are visible at rest. These needs are assessed for other treatments.
Where years of repeated expression have left a set crease in the skin, it may not disappear completely even when the muscle relaxes. For such lines, skin-quality treatments, superficial filler or energy-based devices may form part of the plan. If there is volume loss at the temples or under the brows, toxin alone will not change a tired appearance. Each line has its own cause, so each calls for its own approach.
If there is excess eyelid skin or a significantly low brow, Botox will not correct it and, if poorly planned, can make the heaviness worse. A slight lift at the tail of the brow is possible in some people, but the effect is limited and not appropriate for every face. Setting realistic expectations is one of the most important steps and is discussed openly at your consultation.
Who may not be suitable for upper-face Botox?
Treatment is not given, or is postponed, during pregnancy and breastfeeding, in neuromuscular conditions, when there is infection in the area and in anyone allergic to the ingredients. People with drooping eyelids need particularly careful assessment.
Treatment is not carried out in conditions such as myasthenia gravis, or during pregnancy and breastfeeding. Some medicines that affect nerve-to-muscle transmission can also change the assessment. If there is active acne, a cold sore or infection on the forehead or around the eyes, it needs to heal first. If you have recently had eyelid or brow surgery, timing may be agreed with your surgeon. Please also mention any ongoing dry-eye problems.
Some people with drooping eyelids unconsciously use their forehead muscles to hold their brows and lids up. Relaxing the forehead in these cases can make heaviness in the lids and brows more noticeable. That is why your brow position is examined with your eyes open, closed and in motion. If treatment is not appropriate, you will be told so, and alternatives will be discussed.
How is upper-face Botox done, and what is the aftercare?
After your expressions are assessed, small doses are injected into planned points with a very fine needle; the procedure is usually quick. For the first few hours, avoid rubbing the area or lying flat, and avoid strenuous exercise, saunas and hammams that day.
You will be asked to raise your brows, frown and smile so the strength of the muscles and the position of the lines can be mapped. The plan and possible side effects are explained and your consent is taken. The skin is cleansed and the injections given. Most people feel only a brief pinprick; a cold pack can be used if you are sensitive. Small bumps fade quickly and most people return to their day straight away.
For the first few hours, avoid massaging the area and, briefly, wearing hats or headbands that press on the forehead. The effect begins within a few days and is usually fully settled at around two weeks. A review at this point assesses the balance between the two sides, and a small adjustment can be planned if needed. If you are visiting Istanbul for a short stay, discuss how this review will be arranged.
What are the risks of upper-face Botox?
Common effects are redness, small bruises and a temporary headache. Less often, an eyelid may droop, the brows may look uneven or the tail of the brow may lift too much; these effects are usually temporary.
A drooping eyelid is an uncommon side effect that can occur if the toxin reaches the muscle that lifts the lid; it usually improves within weeks, and your doctor can advise on supportive measures in the meantime. Uneven brows, or a brow tail that lifts more than intended, can often be balanced with a small adjustment at the review. Dry eyes and mild puffiness around the eyes have also been reported.
If, in the days after treatment, you notice changes in your vision, a marked eyelid droop or increasing swelling, contact your doctor. Difficulty swallowing, speaking or breathing is very rare but needs urgent assessment. Before treatment, these risks and the symptoms to watch for are explained to you in detail, and you are encouraged to ask any questions you have.
Frequently asked questions
Which area should I start with if it is my first time?
That depends on which lines bother you most and on your facial structure. A more conservative dose is usually planned for a first treatment, and the result is reviewed together.
Will my brows drop after upper-face Botox?
When properly planned, the aim is to preserve brow position. The risk is assessed more carefully in people who rely heavily on their forehead muscles or who have drooping eyelids.
Can Botox lift the brows?
A slight lift at the tail of the brow is possible in some people. The effect is limited; a significantly low brow may need a different approach.
When can I wear make-up?
Light make-up can usually be applied after a few hours, without rubbing the area. Specific advice is given after your treatment.
Will upper-face Botox help dark circles under the eyes?
No. Dark circles and tear-trough hollows are not caused by muscle movement and are assessed for other treatments.
How long before a wedding or big event should I have forehead Botox?
Forehead, frown-line or crow’s feet Botox is generally advised at least two weeks, and ideally three to four weeks, before an important event. The full effect settles at around two weeks, and this gap allows time for a review, a small adjustment if needed and any bruising to fade. For a first treatment, planning earlier lets you see how the result sits on your face.
Will crow’s feet Botox change my smile?
At a measured dose, crow’s feet Botox usually does not change the smile itself; it softens the creases at the eye corners. If the dose is too high or the toxin reaches the cheek-lifting muscles, the smile can temporarily look different or less lively, and slight under-eye puffiness may become more noticeable in some people. That is why crow’s feet are usually treated cautiously.
Can forehead Botox cause a headache, and how long does it last?
Some people get a mild headache or a tight feeling after forehead and frown-line Botox; this usually settles within a few hours to a few days. Some also describe a heavy forehead in the first weeks. Ask your doctor which pain reliever is suitable, and seek prompt medical advice for a headache that worsens over days, is severe or comes with changes in vision.
My brow tail lifted too much after Botox (a “Spock brow”). What can be done?
An over-arched brow tail, often called a “Spock brow”, can usually be balanced at the review with a small extra dose just above it. It can happen when the centre of the forehead relaxes while the muscle’s outer fibres keep working. The top-up is usually planned after about two weeks, once the effect has fully settled; until then the brow may still change slightly.
Sources (4)
- U.S. FDA (DailyMed, NLM): BOTOX COSMETIC- onabotulinumtoxina injection, powder, lyophilized, for solution (Prescribing Information and Medication Guide) (2026)
- MHRA-approved SmPC via emc (Galderma): Azzalure, 125 Speywood units, powder for solution for injection - Summary of Product Characteristics (SmPC)
- Global Aesthetics Consensus Group (Sundaram et al., Plast Reconstr Surg): Global Aesthetics Consensus: Botulinum Toxin Type A--Evidence-Based Review, Emerging Concepts, and Consensus Recommendations for Aesthetic Use, Including Updates on Complications (2016)
- International Botulinum toxin Advisory board (Ascher et al., Aesthet Surg J): International Consensus Recommendations on the Aesthetic Usage of Ready-to-Use AbobotulinumtoxinA (Alluzience) (2024)
This content is for general information and does not replace a personal medical assessment.