Video to assess facial dynamics before botulinum toxin
Quick facts
- Goal
- Record each patient's contraction pattern to plan and compare the effect of the toxin.
- Script
- Rest, raised eyebrows, frowning forehead, eyes squeezed shut, smile, and pucker.
- Review
- Slow motion and a pause at peak contraction, each side separately.
- Care
- Specific consent, the same framing and lighting, and secure storage of the file.
Botulinum toxin acts on muscle contraction. It makes sense, then, for the assessment to begin by observing contraction. Each person has their own pattern: stronger or weaker muscles, asymmetry between the sides, expression habits that mark one side of the forehead more or one direction of the glabella. That pattern is the basis of the plan.
Photos at rest and in contraction show moments. Video shows the path between them, and that helps you see what a single click misses.
Why do dynamics matter with toxin?
Because the same static wrinkle can have different origins. A line on the forehead may come from a strong frontalis, from a drooping brow compensated by the frontalis, or from the habit of raising the eyebrows. Without observing movement, the plan can end up generic. With it, the professional sees the contribution of each muscle and the asymmetries that call for adjustment.
The same applies to the glabella, where the frowning pattern varies widely between patients, and to the periorbital area, where smiling activates the lateral lines. The concept of dynamic wrinkles explains the difference from wrinkles that persist at rest.
Which expression script should you record?
A fixed script lets you compare sessions. Suggested sequence, with a few seconds on each step:
- Rest: relaxed face, looking at a point straight ahead.
- Raised eyebrows: as in a look of surprise.
- Frowning forehead: as in worry.
- Eyes squeezed shut: as against the sun.
- Wide smile: natural, showing teeth.
- Pucker: as if blowing a kiss.
- Return to rest.
Ask for each expression twice, naturally and without exaggerating. Exaggerated contraction creates patterns the patient does not make in daily life. Keep the same order and pace in every session. Peak photos are covered in dynamic photos for botulinum toxin, photo of the glabella in contraction, and photo of the forehead with raised eyebrows.
How do you review in slow motion?
Review is where video pays off. When watching at reduced speed, observe what happens in each phase of the expression.
| What to observe | Why |
|---|---|
| Which side of the forehead rises first | Reveals contraction asymmetry |
| Eyebrow height at the peak | Shows relative position and compensation |
| Direction and depth of the glabellar lines | Indicates the contraction pattern |
| Orbicularis contribution when closing the eyes | Shows the pattern of the lateral lines |
| Smile symmetry | Shows the dynamics of the elevator muscles |
| Facial habits | Reveal expressions the patient repeats |
Pause at the peak of each expression and extract a frame for the patient record, labeled as a video frame. Write short, objective notes, without drawing conclusions that depend on a physical exam. Remember that video is a supporting tool, and the in-person clinical assessment is the starting point.
What about follow-up after toxin?
The follow-up video repeats the same script, after the time when the effect is usually established. The exact interval depends on the product and is set by the professional according to the instructions for use. Compare with the previous video: was there a reduction in contraction? Did the asymmetry change? Did a neighboring muscle compensate?
Also document any unwanted effect the toxin may cause, such as brow drop or expression asymmetry, without alarmism and with careful records. For the follow-up photo workflow, see when to take the follow-up photo, and for recording an adverse event, complication photo: how to document it.
Consent and privacy
Expression video shows the face in motion and, often, the patient in moments of discomfort. Consent must be specific to video, with purpose, storage, and sharing described, as in consent for clinical video. Brazil's LGPD (data protection law) classifies this data as sensitive. Store it in a secure place with restricted access, and do not send it through personal messaging apps. For storage, see cloud storage for patient photos.
What Harmy does and does not do here
Harmy creates a static projection from one frontal photo per session. It does not analyze video and does not simulate movement or contraction. Among the app's marking points, Glabella appears as a toxin area with symbolic volume, and the projection shows a possibility of smoothing, without predicting how the muscle will respond.
That is why video belongs in the patient record, and the photo at rest, the one that goes into the app, should be neutral and standardized. The simulation is illustrative, at the discretion of the licensed professional, and not a promise of results. See the step-by-step in standardized frontal photo and the explanation of the procedure in toxin in the glabella.
Summary for your routine
Standardize framing and lighting, follow a fixed expression script, review in slow motion, and repeat the same video at follow-up. Use video as an observation aid, never as an injection protocol, and store it with consent and security.
Frequently asked questions
Why record video before applying botulinum toxin?
Because the contraction pattern varies between people and between the two sides of the face. The video records that pattern and serves as a reference for later comparison.
Which expressions should I ask the patient to make?
Rest, raised eyebrows, frowning forehead, eyes squeezed shut, wide smile, and pucker. Always use the same order and ask for each one for a few seconds.
When should I record the follow-up video?
After the time when the toxin effect is usually established, as defined by the professional and the product instructions. Repeat the same script.
Does video replace contraction photos?
No. Contraction photos remain useful as a standardized record. Video shows the movement, and the photo freezes the peak.
Harmy images are illustrative simulations generated by AI from the patient's photo to support the conversation between practitioner and patient. They are not a promise of results. Indication, technique, product and volume are solely the decision of the licensed practitioner. This content is for information only and does not replace a clinical assessment.