BOTOX Terminology: Glabella

What is the glabella?

Glabella has very little to do “gorilla” or “umbrella”.  Although they rhyme.  And if you got a gorilla angry, he/she would have a furrowed glabella.  And if you were caught in the a rain storm without an umbrella.  I think you would also be furrowing your glabella.  And for some patients they look like gorillas if they have very strong muscles in the glabella.

It is the area between the eyebrows above the nose.  Interestingly, it is derived from the latin word “glabellus” which means smooth.  And a smooth glabella is the goal of a BOTOX treatment for the glabella.  We sometimes consider the wrinkles that form in this are the “frown lines” between the eyes or eyebrows.

I'm activating my glabellar complex of muscles here (between the eye brows).
I’m activating my glabellar complex of muscles here (between the eye brows).

Is Glabellar Botox FDA approved?

Yes, BOTOX is FDA approved for cosmetic use in the glabellar complex

How many BOTOX Units are used in the Glabella?

Usually around 20.  But ranges from 12-40 units have been used in my Modesto Botox practice.  Men and younger patients, with their stronger muscles, usually need a higher dose of BOTOX units.  However some younger patients are looking for prevention, and thus may not need as high of a dose.  Customization is key.

What muscles comprise the Glabella?

The procerus muscle in the middle, surrounded by a pair of corrugator/depressor supercilii.  Everyone has different presentations of this muscle.  The anatomy is slightly different for each individual, and the strength of these muscles differ as well.  This leads to individualization of each BOTOX injection.

So basically three muscles:
  • Procerus in the middle
  • Depressor supercilii
  • Corrugator supercilii

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If BOTOX doesn’t work for glabellar creases, what’s next?

Consider fillers for the static lines of the glabella.  BOTOX may work somewhat for the glabellar static lines; however, BOTOX is mainly a treatment for dynamic lines.  Dynamic lines (wrinkles) are formed when the muscle contracts.  Static lines (wrinkles) are present even when the muscles are relaxed.  Many dynamic lines are on their way to static lines – it’s just a matter of time.  However BOTOX can prevent the progression.

What is the best filler for glabellar static lines?

I think this question depends on the injector and how they use the fillers.  This would be an  off-label FDA use of fillers.  I personally prefer Belotero for filling Glabellar creases if it becomes a desired option.   The reason I like Belotero to complement BOTOX treatments in the glabellar region is that it is a light-weight filler which doesn’t easily show up as bumps in the glabellar region.  However if the glabellar lines are very deep and the skin is lax, sometimes a thicker filler such as Juvederm would work better.

More questions about the Glabellar BOTOX injections?

Feel free to make an appointment at our office.  Home page here: Modesto Botox Injections.  Botox injections in the glabella is the most popular use of Botox Cosmetic.