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Related Concept Videos

Muscles for Facial Expressions01:14

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The craniofacial muscles are a collection of approximately 20 thin skeletal muscles situated beneath the skin of the face and scalp. These muscles, primarily responsible for the vast array of human facial expressions, originate from the bones or fibrous structures of the skull and extend outwards to connect with the skin. While most skeletal muscles in the body are enveloped in thick fascia, facial muscles generally have a more delicate fascial covering, with the buccinator muscle being a...
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Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
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Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
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Facial Feedback Hypothesis01:24

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Charles Darwin proposed that facial expressions are an evolutionary adaptation for communication. He argued that these expressions are not influenced by culture but are universal across species. For example, a snarling expression with exposed teeth signals a threat in many animals, including humans. Darwin also suggested that displaying an emotion can intensify the feeling. Smiling, for example, could enhance one's sense of happiness. This idea laid the foundation for understanding the role...
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Related Experiment Video

Updated: Nov 9, 2025

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
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Exaggerated lower frontalis and glabella after Botox injection.

Ebtisam Elghblawi1

  • 1Dermatology Tripoli, Tarabulus, Libya.

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|April 9, 2021
PubMed
Summary

Botulinum toxin injections, like Botox, can rarely cause forehead furrowing. This temporary side effect, often due to muscle compensation, typically resolves within weeks.

Keywords:
attenuationbotulinum side effectsexaggerationforehead horizontal linesforehead patterns

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Area of Science:

  • Cosmetic Dermatology
  • Neurology
  • Plastic Surgery

Background:

  • Botulinum toxin (Botox) injections are widely used for cosmetic and therapeutic purposes.
  • While generally safe and effective, rare adverse events require clinical awareness.

Purpose of the Study:

  • To describe a rare side effect of botulinum toxin injections in the upper face.
  • To inform clinicians about managing forehead complications post-injection.

Main Methods:

  • Case report detailing a patient's experience with Azzalure (a type of botulinum toxin).
  • Observation of forehead muscle activity and anatomical patterns.

Main Results:

  • A patient developed a deep horizontal forehead furrow and glabella projection one week post-injection.
  • This rare complication is hypothesized to result from overactivity of untreated adjacent muscles or unique forehead muscle anatomy.

Conclusions:

  • The observed forehead furrow is a rare, temporary side effect of botulinum toxin.
  • Expected resolution within weeks suggests a dynamic muscular cause.
  • Clinicians should be aware of this potential complication and its likely self-limiting nature.