Horizontal Lines · Brow Position · CityLink Mall
Horizontal forehead lines come from the frontalis, the muscle that lifts your brows. This page is about the brow beneath them: how its height and the upper lids decide how much the forehead can be relaxed, and what helps lines that have set into the skin.
Stretching from hairline to brow, the frontalis is the one muscle that lifts the brows. Each lift folds the skin into horizontal ridges, which young skin smooths out once the muscle lets go.
How hard the frontalis works depends on what it is pulling against.
Types
Before the lines, Dr Sin Yong looks at the brow. At rest it normally sits at or just above the bony rim of the eye socket, its tail a little higher than its inner end. A low brow, or one that jumps up when you look ahead with a slack forehead, suggests compensation.
A simple test helps: close your eyes gently, let the forehead go slack, then open them without lifting your brows. The lid now resting on your lashes is what the forehead has been holding up. The upper lids are also checked for excess skin and for a margin sitting low over the pupil.
The Decision
The frontalis is the brow's only lifter, so a fully relaxed forehead lets the brows settle. In a low brow, or a forehead holding up heavy lids, that reads as heaviness and can push the hood onto the lashes. The brow, not the lines, sets the limit on the dose.
When the forehead is compensating, the plan is cautious and often redirected. The lower frontalis is left working and only the upper forehead softened. The muscles that pull the brows down may be treated so they stop dragging them lower. Where heavy lids are why the forehead works, energy-based lifting aimed at brow and lid, or an eyelid referral, comes before stilling the forehead.
For a comfortable brow, small mapped doses of BTX, a prescription medicine that reduces the nerve signal to the muscle, go across the upper and middle forehead, adjusted for asymmetry. The aim is softer movement, not a forehead that cannot move. The frown is usually treated at the same visit; see forehead and frown lines.
When to wait. Treatment is put off in pregnancy or breastfeeding, with infection in the area, with a neuromuscular disorder such as myasthenia gravis, after an allergic reaction to any botulinum toxin product, and until medicines affecting nerve-to-muscle transmission are checked.
When to refer. A heavy lid caused by the lid itself is a separate problem and is referred to an oculoplastic or plastic surgeon.
At Atelier
A line still visible with the forehead relaxed means the dermis has changed. BTX can be the first stage of the plan, but on its own it does not soften an etched crease. The options at Atelier are:
Safety
Small bruises, tenderness and occasionally a mild headache are common and pass. Three risks belong to the forehead. Too much relaxation for the lids to cope with can leave the brow low or heavy. Medicine reaching the lid-lifting muscle can make an eyelid droop. And if the outer forehead keeps moving while the centre is quiet, one outer brow can arch upward.
Each lasts while the medicine acts and cannot be switched off sooner, though a raised brow can sometimes be evened out (see the questions below). Brow assessment, mapped placement and conservative doses reduce these risks without removing them.
Call the clinic if a drooping lid or brow troubles you, if the two sides look clearly different, or if you see double. Difficulty swallowing, speaking or breathing after BTX needs urgent care at a hospital emergency department: go straight there rather than waiting to reach the clinic.
Atelier Aesthetics · Owned by AYA
1 Raffles Link, #B1-28, CityLink Mall, Singapore 039393 · +65 8023 7170
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