MUSCLE ANATOMY: How to avoid side effects & maximise Botox efficiency [Aesthetics Mastery Show]

Botulinum toxin treatments in the upper face are a real ‘bread and butter’ treatment in most aesthetic clinicians’ practice, but are you familiar enough with the anatomy to avoid side effects, whilst also maximising product efficiency?

In this week’s Aesthetics Mastery Show, Dr Tim takes us on an anatomical tour of the key muscles injected for upper-third Botox treatments, including the frontalis, corrugator, depressor supercilii, procerus, and orbicularis oculi.

He shares why you should avoid paint-by-number injection techniques; the anatomy you need to know in order to avoid eyelid ptoses; how to get procerus toxin doses right; key tips if you struggle to locate muscles in the first place; and the answer to the crucial question of whether you can treat the frontalis without also injecting the corrugator.

Dr Tim even shares a little-known tip to improve rhinoplasty results and longevity…using Botox.

Let us know in the comments if you enjoyed this jam-packed episode, and don’t forget to grab the incredibly helpful free download Dr Tim mentioned in the show: 26 Essential Injection Patterns For Botulinum Toxin – https://drtimpearce.com/resources/26-essential-injection-patterns-for-botulinum-toxin/

00:00
How to upgrade your eyebrow lift game? One of the common struggles of new injectors is how to get a brow lift, or at least how to identify those patients who won’t be getting a brow lift before you try. I’ve done videos on this before, and I’ve annoyed a lot of people by explaining all the principles without showing the exact points to inject. This time I will — but there was an important reason why I didn’t in previous explanations. Are you ready? (upbeat music)

01:00
Don’t forget to give the show a like if it helps you. Here are the injection points to create a brow lift. Doing this on all your patients gives okay results for most, but sometimes bad results — too much lift in some, brow drop in others. Every face is different. Despite the idea of a universal pattern, it doesn’t exist. Each treatment must be tailored to patient’s age, muscle strength, sex, eyebrow shape, and desired result.

Brow Lift: Treatment Design
02:00
We need to understand core principles so we can design treatments for any face. These are like Lego bricks — understand each, and you can build a bespoke design. First, the shape of the ideal female eyebrow: medial border aligns from alar base to inner canthus to brow head; tail aligns from alar base through lateral canthus; arch aligns from alar base through pupil to brow arch. The arch’s position helps identify which muscles to keep strong for lift.

How are the muscles used?
03:00
Eyebrow elevators: frontalis (up and lateral). Depressors: corrugator supercilii, procerus, depressor supercilii (medial head down), orbicularis oculi (pulls eyebrow down in multiple directions). The lateral component is most important. Relaxing certain muscles changes balance of forces, shifting eyebrow position.

04:00
Two main botulinum toxin effects: (1) Relax half of a muscle → other half increases resting tone (useful for treating medial frontalis to activate lateral frontalis); (2) Change vector balance between elevators and depressors. Think tug-of-war — we decide which side wins.

How to create a slight brow lift
05:00
Weakest lift: relax orbicularis oculi at tail of brow (4 units) to create slight lift. Increase lift by treating more of orbicularis oculi medially under brow (1 unit, very superficial). This is low risk for eyelid ptosis. More lift: treat medial frontalis to activate lateral frontalis — a powerful technique.

Avoid! Spock brow
06:00
Don’t treat frontalis without glabella complex in most patients, or you risk Spock brow (over-lifted lateral brow with angry expression). Over-treating medial frontalis can also cause medial support loss and angry look.

Brow lift core principles
07:00
Design treatment using eyebrow shape. Important line: alar base → mid pupil → brow arch → hairline. Keep frontalis along this line active for lift. Avoid creating forehead lines by shaping untreated muscle area. Use “cat ears” triangle to keep lateral frontalis active. Leave 2 cm safety zone above orbital ridge to prevent medial brow ptosis.

How to save on Botox costs
08:00
Mark out areas without frontalis muscle to avoid wasting toxin. What’s left is the medial frontalis ready for treatment. Space injections evenly. Toxin spreads ~1.5 cm per point (about marble-sized). Plan symmetrical injections to avoid asymmetrical brows. Glabella and orbicularis oculi injections often align with licensed positions, adding to lift.

The different brow lifts
09:00
Lift levels:

• Mild: 2–4 units at brow tail
• Mild–moderate: more orbicularis oculi coverage
• Moderate: treat frontalis + glabella
• Maximum: medial frontalis + orbicularis oculi + glabella

10:00
To reduce over-lift, add 1 unit at tip of “cat ear.” You can enhance lift later by adding orbicularis oculi treatment at follow-up. First-time treatments are a journey — adjustments are normal. Bonus: description contains link to botulinum toxin patterns with licensed doses and designs. Licensed line-treatment patterns aren’t meant for brow lifts — they may flatten brows. Apply today’s principles to adapt patterns for best results. (upbeat music)

This episode is ideal for aesthetic practitioners who want a deeper understanding of the key facial muscles involved in upper-face treatments—particularly those seeking to refine injection techniques for natural, harmonious results. It’s especially valuable for injectors who want to prevent complications like eyelid or brow ptosis, adapt treatments to patient anatomy, and move beyond rigid, one-size-fits-all patterns.

Mastering facial aesthetics means knowing not just where to inject, but why. By understanding the anatomy, function, and interplay of muscles like the corrugator supercilii, frontalis, depressor supercilii, procerus, and orbicularis oculi, practitioners can design tailored treatments that preserve expression, maintain balance, and avoid common pitfalls. Careful mapping, dosage control, and staged approaches ensure results that enhance rather than alter a patient’s natural appearance.