Can I get Botox between eyebrows? Does it work for the frown lines?

Is Botox recommended for getting rid of the horizontal crease between the eyes? It’s more than just some vertical lines. The folds are prominent, most probably because of the dramatic amount of weight I lost two years ago. So now I’m planning to get it treated. Any advice?


F, 34, Vermont

Botox is a highly effective noninvasive treatment for facial rejuvenation. It can block the nerve impulses to hyperactive muscles in the glabellar area which cause frown lines. Botox injections in the glabellar area require a comprehensive understanding of facial anatomy and the interaction of adjacent muscle groups and their effects on facial expression. The facial muscles which cause the glabellar lines are among the largest and strongest in the face and often require higher doses of Botox.

With respect to the horizontal line you have noted between your eyes, this is most likely caused by the procerus muscle. The procerus is a pyramid-shaped muscle which extends up from the nasal bone, between the eyebrows to the lower part of the forehead where it attaches to the frontalis muscle. When contracted, it pulls down the skin between the eyebrows.

The procerus generally responds well to Botox injections. A Botox brow lift can elevate the height of your eyebrows, and additional injections can be placed in the crow's feet area to lift the tail of the brow and create a more open-eyed, refreshed look.

Men generally have a stronger procerus and are more likely to notice deep horizontal creases between their eyes. Dermal fillers can also be injected to fill and smooth out the lines. However, both Botox cosmetic injections and fillers will provide temporary results. To maintain your results you will need to undergo maintenance treatments every three to four months. You can first try Botox and then consider other cosmetic surgery options if it does not provide the results you are hoping for.

Another possible surgical option is an endoscopic brow lift. During this procedure, plastic surgeons may weaken certain forehead muscles by severing them where they attach or remove the muscle completely. This will diminish muscle activity in this area, resulting in a more relaxed look. An endoscopic brow lift will refresh the entire brow and forehead area, smoothing out folds and wrinkles and elevating droopy eyelids. To determine the most suitable option to correct your facial lines, consider scheduling an appointment with a board-certified plastic surgeon.

The furrows that can form between the eyebrows are most commonly caused by the muscles in the glabellar complex. These wrinkles are referred to as frown lines, and their appearance can vary from person to person based on the strength of the muscles: some have only fine lines while others have deeper facial wrinkles. While the glabellar muscles usually form vertical lines that look like the number 11, they may also cause horizontal wrinkles that appear across the upper portion of the nasal bridge. Some people notice a bulge in the area when they frown or squint.


The muscle that is most likely responsible for your horizontal lines in this area is the procerus. Botox injections can help to relax this muscle, which will soften the line that is prominent as well as any folds or bulges that appear when the muscle is contracted.

Your practitioner can determine the number of units of Botox required to achieve a beautiful result, with most patients enjoying their results for three-four months. If you are a first time Botox user, it can take several treatments for the lines to really smooth out.

However, deep lines can benefit from dermal fillers such as Restylane or Juvederm to fill out the folds in this area and soften the facial expression. It may also be possible that you would be a better candidate for a cosmetic procedure such as a brow lift that elevates the skin of the forehead to erase prominent frown lines and horizontal forehead lines. Following a brow lift, you will have a more youthful and alert look.

The first and most essential step to determining the correct treatment for you is an in-person evaluation with a plastic surgeon who has experience in facial plastic surgery. He or she will be able to advise you about the most effective treatment to address your concerns.

Absolutely Pamela- that is the most common site for Botox.

Yoash R. Enzer, MD, FACS

Providence, RI

Hi Pamela,

Yes Botox can treat the horizontal lines between your eyes and on the bridge of your nose they are caused by the Procerus muscles. It is a common site for Botox. 

Best of luck!

Dr. Khuthaila

Botox would help with creases in between the eyes.  But there is a possibility that with your weight loss you may need a brow lift.