Understanding Glabellar Line Treatment

We’ve been receiving a number of queries regarding glabellar line treatment recently. 

If you’re confused about frown line toxin or the difference between the glabella and the glabellar, you’re in the right place.

Dr Kalpna Pindolia is an aesthetic medicine specialist and director of education at Harley Academy. She gave us a comprehensive two-part interview on glabellar lines in order to answer all your questions.

Here, in part one of her interview, Dr Kal highlights the anatomical knowledge required. She also prepares you to fully understand patient selection for glabellar line treatment.

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Dr Kal’s advice for understanding glabellar line treatment

“Upper face botox is a foundational skill. These are treatments that most aesthetics practitioners will learn when they first start injectables training,” advises Dr Kal. These botox treatments are covered in both our Foundation and Core Training in Botox and Dermal Filler courses.

“You can get great results treating the glabellar area using standard guidelines. However, there are some intricacies to be aware of to achieve superb aesthetic results!”

Where is the glabella?

“The glabella refers to the depressed region of bone joining the supraorbital bridges, just superior to the nasion,” states Dr Kal.

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What’s the difference between glabella and glabellar? 

“The glabella is the bony region between the eyebrows and the nose. This is a noun,” Dr Kal notes. “As an adjective, glabellar is of, or pertaining to, the glabella.”

Example: “Number 11” frown lines form in the glabella region. They are known as “glabellar” lines as they are lines relating to the glabella.

What does the glabellar complex do?

Dr Kal explains, “Muscles of the glabellar complex include the procerus, corrugator supercilii, depressor supercilii, and the medial part of the orbital orbicularis oculi. 

“The procerus originates from the junction of the inferior portion of the nasal bone and upper lateral cartilage. It ascends superiorly to insert into the glabella. 

“Medial corrugators are confluent, with procerus muscle on either side. They pull the brow medially and inferiorly on either side. Laterally, they become more superficial. This is because they interdigitate with the frontalis muscle before inserting into the skin of the brow. Here, they are referred to as the lateral corrugators. 

“Glabellar complex muscles are depressors of the brow. On contraction, they cause lines and furrows. The procerus muscle generally causes horizontal lines, while the corrugator supercilii muscles produce more vertical lines.”

She also notes, “There is also anatomical muscle variation of the area. As such, a bespoke plan for treating glabellar lines that accounts for this is required to optimise treatment results. 

“Over time, there is repeated pulling of the skin by these dynamic muscles. Combined with skin ageing, this contributes to the formation of more deeply etched static lines and furrows. These are often referred to as frown lines.”

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What treatment do patients ask for when they want their glabella treated?

“Due to its central positioning, the glabella is a region the observer’s eyes are naturally drawn to when processing facial appearance,” says Dr Kal. 

“As lines in this area become more prominent, there are a number of concerns patients may raise,” she says.

– Worried they look like they are frowning

– Concerned they look angry all the time

– Troubled by the appearance of “number 11s” or “worry lines”.

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What concerns does glabellar toxin address?

“By managing the glabellar complex depressors with botox, the lines become less prominent. Additionally, as the region lifts a little, the eye area looks more open,” Dr Kal states. “This creates a more refreshed, awakened and rejuvenated appearance.”

She adds, “The effect of glabellar line treatment is temporary, with results peaking at 4 weeks. Most of the muscles recover by 3-4 months, when repeat treatment may be considered.”

What makes a good candidate for this treatment?

“Worry lines can appear as early as in the twenties. As long as the treatment is not medically contraindicated, most patients will benefit from this treatment,” Dr Kal reveals. “This is because elevation of the brow will, at a minimum, create the illusion of a well-rested, open eye region.”

She also counsels, “If a patient has deep static lines, toxin treatments may improve the appearance of glabellar lines. However, they are unlikely to eradicate them, so other treatments may be considered as well.”

When is glabellar line treatment contraindicated?

“The usual toxin contraindications apply,” reminds Dr Kal. “For example, hypersensitivity, disorders involving defective neuromuscular transmission, infection or inflammation of local skin. Or, where patients have unrealistic expectations about the treatment.”

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Learning to perform glabellar line treatment

Now you understand the “what”, “why” and “who” of glabellar line treatment. In part two of our interview with Dr Kal, we’ll explore the “how” with injecting and product selection advice.

In the meantime, if you’ve been inspired to start your journey towards aesthetic excellence, book a call with one of our Student Recruitment team. They’ll be able to advise you on the best injectables training course for your needs and answer any questions, from content to payment options.

Please note Harley Academy aesthetic medicine training courses are open to licensed doctors, dentists, nurses and midwives.

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