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Down with the frown – banish the vertical forehead lines that make you look grumpy Glabellar lines are the short vertical lines between the eyebrows, which are also called frown lines. The glabella lines make you look quizzical, angry, grumpy and annoyed.
Patients start to notice glabellar lines when they are in their thirties. These lines are usually about 1cm or 1.5cm in length and can be slightly deeper on one side than the other. People in the United States call them the “11s”. The glabella lines are a tell-tale sign of ageing, and for a young person, it is usually the first area requiring cosmetic rejuvenation with Botulinum toxin A chemodenervation.
At Clinica London, I will see you for treatment of your glabellar lines and advise at an aesthetic consultation whether it is the only aspect of early ageing that requires treating, or whether there are other signs, such as early skin pigmentation, dyscrasias, clumpy freckles, small blood vessels or large pores that also need addressing before they worsen.
When assessing a patient for glabellar lines treatment with Botulinum toxin A, I will ask you to make certain facial expressions for me, and I will observe the muscle groups responsible for the various movements around the eyes and on the face.
In particular, I will ask you to frown at me and look very angry – as though I have just stepped on your toes and you are wearing your best shoes; it hurts a little bit, and I may also have scuffed them. So you will look furious and growl at me! Then I can see how strong your corrugator and procerus muscles are – these are the muscles responsible for the vertical glabella lines.
The strength of the forehead muscles varies between individuals and depends on things like the length of the forehead and the strength of the orbicularis and, of course, genetic factors.
I will then ask you to lift your eyebrows high and show me the horizontal lines on your forehead so that I can see how strong your frontalis muscle is. Because if your forehead muscles are not strong enough, there is no point in me paralysing your glabellar lines with Botulinum toxin A, as I could risk giving you “brow droop”.
As you get slightly older, you may want me to treat the horizontal lines on your forehead with light Botulinum toxin; therefore, I need to assess whether or not that is yet required.
Whenever I treat the glabella lines, I always make sure I do a little treatment on the upper outer brow to stop you looking like Mephisto or Mr Spock from Star Trek. It is essential to maintain your normal eyebrow curvature and not change this or make you look as though you have had bad Botulinum toxin anti-wrinkle treatment.
I like to do a balanced treatment of the forehead, glabella and the upper outer brow so that I get rid of your vertical furrows, the glabella lines. I will also treat your horizontal forehead lines if required and I open up your eyebrows so that you have a nice open-eyed look without looking startled, but just so that you are looking refreshed, bright and lively.

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