Frown Line (Glabellar Complex) Anti-Wrinkle Injection Policy

Published:

November 4, 2025

1. Purpose

Provide a safe, evidence-based framework for administering botulinum toxin type A (BoNT-A) to the glabellar complex (frown lines) in accordance with Australian medical governance and current international consensus. ¹

2. Scope

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

3. Governance (Australia)

Requires a face-to-face prescriber consultation, adherence to TGA advertising restrictions, and record keeping per NSQHS clinical governance standards. ¹

4. Regional Anatomy & Injection Mapping

The glabellar complex includes the procerus, corrugator supercilii, and depressor supercilii muscles. Consensus technique: five injection points — two in each corrugator and one in the procerus, avoiding supra-orbital vessels. ⁴

5. Dosing (Australian Product Information)

As per Australian-approved product information, inject approximately 20 Units total (4 Units per site × 5 sites) for onabotulinumtoxinA or dose per individual product label (e.g., Letybo, Relfydess). Adjust for anatomy, muscle strength, and previous response. ⁵

6. Contraindications

Defer treatment in pregnancy, breastfeeding, local infection, or neuromuscular disorders; review medical and allergy history before proceeding. ²

7. Informed Consent & Risks

Discuss expected outcomes (softening of lines, not removal), possible bruising, brow heaviness, or eyelid ptosis from toxin spread, and the need for repeat dosing every 3–6 months. ¹

8. Post-Treatment Care

Advise patients to stay upright ≥ 4 hours and avoid rubbing, exercise, or heat exposure for 24–48 hours. Schedule review at 2 weeks for dose symmetry and satisfaction. ²

9. Adverse Events & Management

Eyelid or brow ptosis may be treated with apraclonidine 0.5 % drops and documented review. Bruising is typically self-limiting; reassure patient and monitor. ⁶

10. Documentation & Audit

Record prescriber, injector, product, batch, expiry, dose, site map, consent, and post-procedure notes. Maintain annual audits and ≥ 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 (onabotulinumtoxinA) and Relfydess (abobotulinumtoxinA) for Glabellar Lines., viewed 04 November 2025, https://www.tga.gov.au ↩
Nestor MS, Ablon GR, Newburger J, et al. 2021, Botulinum Toxin–Induced Blepharoptosis: Anatomy, Etiology, and Management, Journal of Cosmetic Dermatology, 20(8):2314–2322., viewed 04 November 2025, https://onlinelibrary.wiley.com/doi/10.1111/jocd.14361 ↩

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.