The frown line, or glabellar line, is an expression wrinkle located between the two eyebrows. It is caused by the repeated contraction of the corrugator and procerus muscles, particularly active during negative emotions such as anger, stress, or intense concentration. Very common, it can appear early, as soon as the thirties, giving the face a harsh, closed, or tired expression.
Among the available treatments, botulinum toxin (Botox®) injections stand out as a reference solution. But what can be expected in terms of results ? What do the before-and-after photos show ? When is the effect visible, and is it natural ? This article answers these questions based on clinical experience and objective patient feedback.
In the majority of patients, the frown line first appears intermittently, only during certain facial expressions. It is then called a dynamic wrinkle, visible only during muscle contraction. But over time, with repeated contractions, this wrinkle can deepen and become visible even at rest, becoming a static wrinkle.
“Before” injection photographs generally show :
Treatment at this stage can prevent worsening and correct the wrinkle if it is not yet too deep.
“After” injection photos — generally taken two weeks later — show a clear yet subtle transformation, primarily based on targeted muscle relaxation. Botulinum toxin works by temporarily blocking nerve transmission in the muscles responsible for the wrinkle, without affecting other facial expressions.
In the days following the injection, the frown line gradually softens. When the result is optimal, two weeks after injection, one observes :
The before-after contrast is often striking, especially in very expressive patients.
Botulinum toxin does not act immediately : it usually takes 3 to 5 days to observe the first improvements, with an optimal effect between the 10th and 15th day. This is the ideal time to take a comparative photo or schedule a follow-up consultation.
Before/after photographs taken at day 15 generally show a clear correction of the wrinkle. The gradual progression preserves mobility and prevents any frozen or artificial appearance. This smooth onset of the result allows for its natural integration into the patient’s expressions.
To correctly assess the results of a Botox treatment on the frown line, it is essential that the before and after photos are taken under identical conditions : same lighting, same framing, without makeup and without voluntary expression.
This photographic standardization is crucial to objectively evaluate the evolution. During the consultation, it also allows the patient to visualize more clearly the real benefit of the treatment, sometimes more evident in the image than in the mirror. A photo comparing the voluntary contraction of the eyebrows before and after injection clearly illustrates the muscular inhibition effect achieved.
When the frown line is very deep, particularly in patients over 45 or very expressive, Botox alone is not always sufficient. The muscular relaxation achieved stops further worsening, but the skin crease may persist at rest.
In these cases, a combined protocol is proposed : an initial injection of botulinum toxin to inhibit contraction, followed 10 to 15 days later by an injection of very fluid hyaluronic acid to fill the crease.
Before/after photographs in this type of protocol are particularly demonstrative : the vertical fold is erased, the glabella is smoothed, but facial expression remains natural. This two-step treatment often yields a very high satisfaction rate.
Beyond the image, one element frequently mentioned by patients is the sensation of muscular relaxation in the forehead and glabella. Many describe an “inner calm,” a feeling of tranquility difficult to quantify but decisive for their comfort after injection.
This subjective dimension, invisible in photos, largely contributes to the high level of satisfaction highlighted in clinical studies and follow-up surveys.
In photos taken three months after the session, a good persistence of the result is generally observed, even if slight muscular activity may reappear. From the fourth or fifth month, the dynamic wrinkle tends to reform during contraction. This gradual return, never abrupt, allows for a calm anticipation of the maintenance session, usually scheduled around the fifth or sixth month.
Over time and with repeated sessions, the “before” photographs show progressive improvement : the wrinkles appear less marked, as muscular contraction weakens permanently. Botox does not only have an immediate effect : it also helps prevent the worsening and recurrence of a deep frown line.
Several studies published in aesthetic dermatology and aesthetic medicine journals have objectively evaluated the results of Botox injections in the glabella using validated visual scales, such as the Facial Wrinkle Scale or the Glabellar Line Severity Scale (GLSS). These studies confirm that in over 80% of cases, frown line severity scores decrease by at least two grades on the clinical scale as early as the second week after injection.
Standardized before/after photographs taken in these trials show results consistent with those observed in practice : visible improvement of the wrinkle, enhancement of eye dynamics, and disappearance of involuntary facial tensions. These data objectively support what consumer photos intuitively show : a clear yet natural correction.
Article written by Dr Romano Valeria
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