Forehead (Frontalis) Anti-Wrinkle Injection Policy

Published:

November 4, 2025

1. Purpose

Provide a safe, evidence-based framework for botulinum toxin type A (BoNT-A) treatment of horizontal forehead lines (frontalis) consistent with Australian medical governance and current clinical consensus. ¹

2. Scope

Applies to AHPRA-registered practitioners performing or supervising anti-wrinkle injections to the forehead (frontalis region), including assessment, dosing, consent, and follow-up. ¹

3. Governance (Australia)

Requires a face-to-face prescriber consultation, compliance with TGA advertising rules, and clinical documentation according to NSQHS governance standards. ¹

4. Regional Anatomy & Injection Mapping

The frontalis muscle elevates the eyebrows and produces horizontal lines. Consensus technique: multiple small injection points across the upper two-thirds of the forehead, maintaining at least 2 cm above the brow to avoid brow ptosis. ⁴

5. Dosing (Australian Product Information)

Typical Australian-approved total dose: 10–20 Units of onabotulinumtoxinA (or equivalent) distributed across 4–8 injection sites; dosing must be individualised per muscle strength, gender, and prior response. ⁵

6. Contraindications

Defer in pregnancy, breastfeeding, local infection, or significant neuromuscular disorders. Review all medical and medication history before injection. ²

7. Informed Consent & Risks

Explain expected outcomes (softening of lines, not full removal), possible bruising, heaviness, or brow ptosis from diffusion, and need for repeat treatment every 3–6 months. ¹

8. Post-Treatment Care

Stay upright for at least four hours; avoid rubbing, vigorous exercise, saunas, or facials for 24–48 hours; reassess at two weeks for symmetry and satisfaction. ²

9. Adverse Events & Management

Brow ptosis may respond to cautious use of apraclonidine 0.5 % drops; review and document outcome. Bruising is self-limiting; reassure and monitor. ⁶

10. Documentation & Audit

Record prescriber, injector, product, batch, expiry, total dose, injection map, consent, and review notes. Maintain annual audit and at least 20 hours CPD in cosmetic injectables. ³

Sources

AHPRA 2025, Guidelines for Cosmetic Medical and Surgical Procedures, Canberra., viewed 04 November 2025, https://www.ahpra.gov.au/News/2025-09-02-New-guidelines-for-cosmetic-procedures.aspx ↩
Queensland Health 2024, Beginner’s Guide to Cosmetic Injectables, Brisbane., viewed 04 November 2025, https://www.health.qld.gov.au/newsroom/news/beginner-friendly-guide-to-cosmetic-injectables ↩
Australian Commission on Safety and Quality in Health Care (ACSQHC) 2023, NSQHS Standards – Medication Safety, Sydney., viewed 04 November 2025, https://www.safetyandquality.gov.au ↩
Ascher B et al. 2024, International Consensus Recommendations on the Aesthetic Usage of Ready-to-Use AbobotulinumtoxinA (Alluzience), Aesthetic Surgery Journal, 44(2):192–202., viewed 04 November 2025, https://academic.oup.com/asj/article-abstract/44/2/192/7231033 ↩
Therapeutic Goods Administration (TGA) 2023, Australian Product Information – Letybo and Relfydess for Frontalis Lines., viewed 04 November 2025, https://www.tga.gov.au ↩
De Boulle K, Carruthers A, Solish N, Carruthers J, Phillipp-Dormston WG, Fagien S, Sangha S, Silberberg M, Mao C., OnabotulinumtoxinA Treatment for Moderate to Severe Forehead Lines: A Review. (2020) Plast Reconstr Surg Glob Open, viewed 04 November 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC7253259/ ↩

Disclaimer for Newcastle Cosmetic Doctor Policies & Procedures

The policies and procedures contained within this document are the exclusive property of Newcastle Cosmetic Doctor and are provided for internal clinical governance and educational purposes only. These materials represent the internal operational framework, safety standards, and evidence-based protocols developed and implemented by Dr. Bart John Scanlon and the Newcastle Cosmetic Doctor team. They are designed specifically for use within Newcastle Cosmetic Doctor and reflect our clinic’s own professional standards, risk assessments, and compliance obligations under Australian law and regulatory authorities. External individuals, practitioners, or organisations must not copy, reproduce, distribute, or rely upon these materials, in whole or in part, for their own clinical, commercial, or educational use without prior written consent from Newcastle Cosmetic Doctor. These materials do not constitute medical, legal, or professional advice and are not intended to be adopted as official protocols or procedures by any other entity. Any external use or adaptation must be independently reviewed and modified to meet the relevant laws, guidelines, and standards applicable to the user’s own jurisdiction, scope of practice, and facility operations. Newcastle Cosmetic Doctor and Dr. Bart Scanlon accept no liability for any loss, injury, or damage arising from the unauthorised use, reliance upon, or misinterpretation of this material.