Differences in injecting Botox for a Male vs Female patient?

Author

Dr. Stephen Cosentino

What is the difference in injecting Botox on a Male patient vs a Female patient?

We are going to discuss specifically how to inject the Forehead region with Botox Cosmetic in a male vs a female patient. The technique itself is not difficult, however; if performed incorrectly the result will be horrible and your patient will be disappointed. There are many “pearls” we teach at the Botox Training program but I believe this is one of the more important ones because this procedure is so commonly performed incorrectly. Many physicians and others injecting Botox Cosmetic simply target lines and wrinkles throughout the face, looking to correct these defects without having a complete understanding of how to properly “sculpt” the face or how having an understanding of muscle anatomy will affect the end result. Botox is not just an anti-wrinkle treatment and if used properly can accomplish much more. During our Botox program, we teach the art of sculpting and contouring the face using Botox Cosmetic. It is important to understand the techniques of Botox injections with an understanding of the muscles involved and how to target certain muscles to achieve the best results. Let's discuss Male vs Female techniques in injecting Botox Cosmetic. There are many areas that can be injected in the face but for this discussion we will only concentrate on the most common area, the Forehead (Frontalis Muscle).

The Frontalis muscle which is also known as the Occipitofrontalis or epicranius muscle is a very thin muscle located on the front of the head. There are no bony attachments and the medial fibers are continuous with those of the Procerus muscle, which is a constituent of the Glabellar complex. It is important to understand this attachment so that when you inject into the Glabellar area you do not inadvertently inject fibers of the Frontalis. (A discussion for the next topic- don’t worry, simple). The primary function of the Frontalis is elevation, lifting the eyebrows, opposing the orbital portion of the orbicularis and the Glabellar complex which acts as a depressor. Botox serves to relax muscles by blocking the release of ACH at the neuromuscular junction. When injecting a male patient, or a female patient for that matter, let's keep in mind what is actually happening. Yes, we know that we are going to relax those rhytids in the forehead region, but we are also going to relax the Frontalis muscle as well. What happens next after injection is the opposite effect of the primary action of the muscle. The Frontalis muscle will relax and shift downward towards the eyebrows. Here is what you have to be careful of and make sure you create a distinction when injecting a male vs a female. Females typically request a slight lateral eyebrow lift. There are several ways to accomplish this, not difficult but saved for the next discussion. Not only to Male patient does not ask for this result, but they will also look “odd” or distorted if you inadvertently create this. When injecting a Male patient, make sure you begin your injection laterally and move your injections across the forehead. Often times I see patients in my office that come to me for a correction of a Botox procedure performed by their previous doctor. I believe these are the more stubborn, cavalier doctors who either learned to perform Botox Cosmetic from a book or attended a lower quality Botox program. These techniques are not difficult but need to be practiced. Make sure when you attend a Botox event you have lots of injections under your belt. Back to the lateral injections. If you begin by placing your first injection laterally and move across the forehead, the forehead will depress symmetrically. Many times patients present with rhytids primarily in the central part of the forehead. The natural tendency for the injector is to target this area and not laterally. Let's try to imagine the result of this. Injecting Botox Cosmetic in the central part of the forehead will cause only the central part of the forehead to depress. The lateral frontalis will remain intact and retain its primary function as an elevator, thereby lifting the lateral part of the forehead. The end result will be eyebrows that are pointed upwards, altering the expression of your patient, creating a mean- angry appearance. If you are treating a female patient or a male patient who wants this lateral eyebrow lift, then ok you can target only rhytids in the central frontalis region. Male and Female patients should be treated by placing the initial injections laterally and move across the forehead. By not injecting the lateral portion of the Frontalis you will create pointed eyebrows. Unless this pronounced, bilateral lateral eyebrow lift is the desired effect of your patient, make sure you begin your injections laterally. If you have recently attended an Empire event and have questions about the procedure, please feel free to contact my team directly at our training center. Empire Medical Training works with a physician staff of over 40 specialists in different areas of Aesthetics. Since 1998 we have provided Botox Training programs around the country. To find the closest training location, visit our calendar section of the website or contact us directly at 866-333-6747.