Smoothing frown lines with botulinum toxin
Before treatment : a dynamic wrinkle developing into a permanent crease
In most patients, a frown line initially appears intermittently, only during certain facial expressions. This is a dynamic wrinkle, visible only during muscle contraction. Over time, however, repeated contractions can deepen the wrinkle until it becomes visible even at rest, turning into a static wrinkle.
Photographs taken before injections generally show :
- A more or less pronounced vertical crease between the eyebrows, sometimes a double crease.
- A tense, contracted area between the eyebrows.
- Eyes perceived as harsh or stern, contrary to the patient's actual emotional state.
Treatment at this stage can prevent worsening and correct the wrinkle if it is not yet too deep.
After botulinum toxin injections : smoother wrinkles and more open-looking eyes
Photographs taken after injections — generally two weeks later — show a clear but subtle transformation, primarily based on targeted muscle relaxation. Botulinum toxin temporarily blocks nerve transmission to the muscles responsible for the wrinkle without changing other facial expressions.
In the days following injections, the frown line gradually softens. When the result is optimal, two weeks after injections, the following changes can be observed :
- Disappearance or substantial reduction of the wrinkle, even during muscle contraction.
- Visible relaxation of the glabella, with smoother, more relaxed skin.
- Improved symmetry of the upper face.
- Eyes that appear more open and less closed, without a frozen effect.
- A more neutral, calmer facial expression.
The before-and-after contrast is often striking, especially in very expressive patients.
How soon are results visible in photographs ?
Botulinum toxin does not act immediately : initial improvements appear after an average of 3 to 5 days, with optimal effects between the 10th and 15th day. This is the appropriate time for a comparison photograph or follow-up consultation.
Before-and-after photographs taken on day+15 generally show clear correction of the wrinkle. The sufficiently gradual development preserves movement and avoids a frozen or artificial appearance. This gentle emergence of the result allows it to integrate naturally with the patient's expressions.
Before and after : assessing results
To assess botulinum toxin treatment for frown lines properly, before-and-after photographs must be taken under identical conditions : the same lighting and framing, without make-up or deliberate expression.
Standardised photography is essential for an objective assessment of change. During consultations, it also helps patients see the treatment's real benefit more clearly, sometimes more obviously in an image than in a mirror. A photograph comparing deliberate eyebrow contraction before and after injections provides a particularly clear illustration of muscle inhibition.
Deep wrinkle treatment : before and after
When a frown line is very deep, particularly in patients over 45 or those who are very expressive, botulinum toxin alone is not always sufficient. The muscle relaxation prevents further worsening, but the skin crease may persist at rest.
In these cases, a combined protocol is proposed : an initial botulinum toxin injection to inhibit contraction, followed 10 to 15 days later by an injection of very fluid hyaluronic acid to fill the crease.
Before-and-after photographs with this protocol are particularly illustrative : the vertical fold is smoothed away and the glabella looks smoother, while facial expression remains natural. This two-stage treatment often achieves very high satisfaction.
Beyond the image, however, patients frequently mention another element : the sensation of muscle relaxation in the forehead and glabella. Many describe an “inner calm”, a feeling of tranquillity that is difficult to measure objectively but decisive for their comfort after injections.
This subjective aspect, invisible in photographs, contributes substantially to the high satisfaction shown in clinical studies and follow-up surveys.
How long results last
Photographs taken three months after treatment generally show good persistence of the result, although slight muscle activity may return. From the fourth or fifth month, the dynamic wrinkle tends to reappear during contraction. This gradual, never abrupt return allows maintenance treatment to be planned calmly, usually around the fifth or sixth month.
Over time and with repeated sessions, photographs taken before treatment show progressive improvement : wrinkles appear less pronounced because muscle contraction weakens over the longer term. Botulinum toxin offers more than an immediate effect : it also helps prevent worsening and the return of a deep frown line.
Before and after : clinical studies
Several studies in aesthetic dermatology and aesthetic medicine journals have objectively assessed glabellar botulinum toxin injection results using validated visual scales, such as the Facial Wrinkle Scale or Glabellar Line Severity Scale (GLSS). They confirm that in more than 80 % of cases, frown line severity scores decrease by at least two grades on the clinical scale from the second week after injections.
Standardised before-and-after photographs from these trials show results consistent with clinical practice : visible wrinkle improvement, improved dynamics around the eyes and disappearance of involuntary facial tension. These findings objectively support what publicly available photographs convey more intuitively : clear yet natural correction.
