Let's talk about things to consider when assessing your patient's face before treatment with a neurotoxin.
Firstly - know your muscles. 2 points to consider at the eye area: do they have a natural brow ptosis or droopy eye lids?
The frontalis when relaxed will potentially worsen this area, therefore patient selection for treatment of this area is essential.
You must explain to these patients that the risk of eyebrow ptosis is high, and they are not truly suitable for the frontalis treatment.

If you have a treatment where the eyebrow raises too much it will be due to underdosing of the frontalis. The way to correct this is to dose 1 or 2 Toxin units to the frontalis 2.5cm above the highest peak of the raised brow. A point to consider is to ask your patient if they have ever had this type of reaction before and explain how this can be corrected.

Another point to consider when assessing your neurotoxin patient is their hairline, especially male patients. You will need to inject the frontalis where the hairline would have been naturally using the normal prescribed dose of neurotoxin.
Be prepared that this patient will return for review and will need more toxin administered at the review stage where the lines are still visible and usually higher on the frontalis as well.
One more point to consider is the patients’ brows, have they been micro-bladed or tattooed, if so then you must use your natural anatomy to assess the corrugator muscle points and not the brow as the false brow will normally be higher than the natural brow. Natural movement and watch and feel the muscle are a good tip to assess here.

If you'd like to learn more about botulinum toxin, you can attend our Advanced Training Course on the 18th of May!
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