How To Perform a Botox Brow lift on a small forehead

In this episode Dr Tim demonstrates his technique for Botox on a small forehead. He shares how to inject the frontalis, corrugators and crows feet whilst also performing a brow lift.

If you struggle with worry over causing complications, you would benefit from Dr Tim’s live webinar about how to overcome complications anxiety.

0:00 – 1:00
So this week I’d like to share with you some bread and butter treatments—stuff you need to get right day in, day out. This is a very typical early-30s refresh: soften a few lines and slightly lift the brow. Very simple treatment. I hope you enjoy.
Creating an eyebrow lift often involves treating the glabella. Here I’m marking out the five central points of the corrugator muscle—the serious medially, and two injection points. To understand eyebrow lift, you have to understand the eyebrow’s current position and why it’s held there by the muscles in place. The frontalis muscle pulls up; the glabella complex pulls down and medial, with a small contribution from the procerus. The biggest brow depressor is the orbicularis oculi muscle. In this tug-of-war between frontalis and orbicularis oculi, the first way to cause a little lift is to relax orbicularis oculi. The simplest way is with four units to the tail of the eyebrow. This takes pressure off the downward pull and causes a small lateral lift—best when you see a clear inferior-medial brow depression caused by orbicularis oculi.

1:00 – 2:00
We need to assess the muscle and look for that depression. You can see small brow depressions here—positive for creating a small brow lift. This patient also wants softening of lines around the eyes, so we’re treating that too, which can help with brow lift. The tug-of-war is likely won by the frontalis muscle if we relax the depressor, orbicularis oculi. You can increase the chances of lift by treating a small amount of orbicularis oculi underneath the eyebrow—the superior aspect of the muscle is most involved with pulling the brow down. Another method is to increase the resting tone of the frontalis muscle where it lifts the brows most. We do this by treating the medial aspect where we don’t want a lift and leaving the lateral aspect untreated. Untreated muscle next to treated muscle often increases resting tone—something we can use to cause a lift.

2:00 – 3:00
We must lift the eyebrows strategically. We don’t want a medial brow drop with a lateral brow lift because that looks like a “Spock brow.” The ideal eyebrow shape is dictated by the position of the arch—on a line from the alar base, through the mid-pupil line, and through the arch. I like to mark a target point along this vector. The line of pull should follow that direction. Once you know the direction of pull, you select the muscle area you do not wish to treat, hoping for increased resting tone there. I mark out the tail of the brow and choose an equidistant point medially, creating a triangle of untreated muscle.

3:00 – 4:00
With new patients, it’s safer to leave areas untreated and adjust on follow-up. In this case, I’m not treating the top of the “cat ears” I’ve drawn, to reduce the risk of brow drop. The most important thing to prevent Spock brow is not to overtreat the frontalis here. Many inject too high because they misunderstand the anatomy of the corrugator supercilii. Some see a bulge when the patient frowns and think that’s the corrugator, but it’s actually caused by one muscle pulling medially and another pulling down. Injecting here risks knocking out the central frontalis while leaving the lateral active—causing a Spock brow.

4:00 – 5:00
So, don’t inject too high. I leave a two-centimeter safety margin, giving me space to treat corrugator supercilii and still leave some frontalis muscle untreated. I use a larger margin if there are fewer lines/wrinkles medially. This patient doesn’t have much of an aponeurosis, so I can fill the space with one- to two-unit injection points, each diffusing about 1.5 cm in circumference.

5:00 – 6:00
Summary: mild medial frontalis relaxation with medial support (to avoid brow drop); corrugator supercilii and procerus relaxed; lateral frontalis untreated to enable lift; orbicularis oculi treated to soften lateral canthal lines and elevate the brow. Injecting superior to the brow requires extreme superficiality—only 2 mm deep, one unit. Too deep risks bruising and affecting orbital structures without benefit. Depth is the main safety measure.

6:00 – 7:00
Repeat on the other side—superficial one-unit injections. Never go through the pigmented area to avoid tattooing. Treating the corrugator supercilii: apply orbital rim pressure, inject four units into procerus, medial corrugator (thicker muscle), and lateral corrugator (thinner). Depth changes—start deep, become superficial laterally.

7:00 – 8:00
Frontalis injections: simplest type. Pop through dermis, hypodermis, and into where the muscle is—one-unit doses. Quick and easy once markings are done.

This episode is ideal for aesthetic practitioners, injectors, and medical professionals who want to refine their brow-lifting techniques and avoid common pitfalls like the “Spock brow.” It’s also valuable for those seeking a deeper understanding of facial anatomy—particularly how the frontalis, glabella complex, procerus, corrugator supercilii, and orbicularis oculi interact to shape brow position and expression. Whether you’re new to injectables or an experienced clinician looking to perfect subtle, natural-looking results, this discussion offers practical, anatomy-based strategies you can apply immediately.

Achieving a balanced, natural brow lift requires precise anatomical knowledge, strategic muscle targeting, and restraint to avoid overcorrection. By relaxing key depressor muscles, preserving lateral frontalis function, and carefully controlling injection depth and dosage, practitioners can create subtle elevation that refreshes the face without distorting expression. Remember, less is often more—especially with first-time patients—and follow-up adjustments can fine-tune results for optimal lift and symmetry. When done thoughtfully, this approach softens lines, enhances the brow’s natural shape, and delivers the refreshed, harmonious look patients desire.