Forehead photo with raised eyebrows for documentation

The forehead tells two stories at once: the horizontal lines, which depend on the frontalis muscle, and the position of the brow, which the frontalis itself helps to support. Photographing the forehead with the eyebrows raised documents the first. Photographing it at rest documents the second. Without both, the baseline record is incomplete, and any later complaint of a "drooping brow" has no reference.

This page shows how to photograph the forehead in a standardized way, to plan and to document the follow-up. The text is about recording, not injection technique.

What does the frontalis do and why does it matter in the photo?

The frontalis muscle raises the eyebrows and forms the horizontal forehead lines. It is the only brow elevator in this region, and many people use it as compensation to keep the eyes open, especially when there is eyelid droop or laxity. Documenting the elevation shows how much the patient relies on the muscle and how these dynamic wrinkles are distributed.

This helps explain the indication, align expectations and compare the response at follow-up. For the anatomy, see the muscle map for botulinum toxin and forehead lines.

Which poses should you photograph?

Photograph the resting pose first, leave a few seconds of pause, and then do the movement poses. There is a link to the glabella pose: see the photo of the glabella in contraction, which is usually taken in the same session.

How do you guide the patient?

1. Ask them to look at the dot on the wall, with the face relaxed.
2. Photograph at rest, in a short burst.
3. Say: "Now raise your eyebrows, as if surprised, and hold."
4. Photograph the elevation and ask them to release.
5. Repeat the pose if the first one was not faithful.

Avoid demonstrating with your own face, and avoid commands like "make a startled face", which leads to exaggeration. The expression script and common mistakes are in neutral expression in the clinical photo.

Light, angle and background

Use soft light, from the front and slightly above, to reveal the lines without creating hard shadows under the brow. Avoid light coming from too high above, which shadows the eyes, and avoid flash. Place the lens at eye level, keep the Frankfort plane horizontal, and frame from the top of the head to the nose at minimum, but preferably the whole face to keep the routine. Hair tied back or moved away from the forehead: see tied-back hair in the clinical photo.

If the patient has bangs or hair covering the hairline, tie it back or move it away with a neutral clip. The forehead must be fully visible, from hairline to eyebrows.

Cautions when interpreting

• Asymmetry: the frontalis is often asymmetric. Record it without correcting, and read it together with the natural asymmetry of the face.
• Compensation: someone who uses the frontalis to open the eyes may show strong lines at rest and softer ones on elevation. The clinical reading takes this into account.
• Forehead skin: shine and sweat show up easily. Dry the forehead before the photos.
• Makeup: foundation and powder hide fine lines; photograph without makeup (makeup in the clinical photo).

What should go in the chart?

Date and time, poses taken, command used, a brief description of the resting brow position, the patient's concern and consent for image use. To store and protect the record, see storing patient photos and image consent for clinical documentation.

And in Harmy?

Harmy has no marking point for the forehead, and the simulation uses the frontal photo at rest. The raised-eyebrow photo is a separate chart record. Because the projection keeps the expression of the original photo, do not use a photo with raised eyebrows as the base: it would compromise the reading. See single frontal photo for planning in the app.

When raising the eyebrows is misleading

Patients who use the frontalis to compensate for heavy eyelids often raise their eyebrows without realizing it, even at rest. If the resting photo already shows a furrowed forehead, ask the patient to close the eyes, relax and open them slowly, without raising the eyebrows, and photograph right away. Note that there is compensatory use of the frontalis. This observation matters for planning and for the conversation with the patient, but clinical interpretation belongs to the qualified professional, after the examination.

Summary

Rest first, elevation second, the same command every time, and the brow position noted. That way the forehead is documented with frontalis dynamics and with the reference needed to assess the follow-up.