For wrinkles on the forehead, Botox can work quite well, but there are other options. First and foremost, the two injectable medications that are very similar to Botox but made by other companies include Dysport and Xeomin. Both of these are nearly identical to Botox on a molecular level and work in a similar fashion (by relaxing the muscles in the affected area). Other alternatives for forehead wrinkles include fillers, skin resurfacing, and surgery. I do not commonly use fillers in the forehead simply because Botox, Dysport, and Xeomin work so well and give a very nice result, but fillers can be used to fill in certain deep, static lines in the forehead in select patients. Skin resurfacing (peels or lasers) can work well in the forehead area and other areas of the face as well. To get a significant improvement, there is generally some down-time involved, which is not the case with an injectable treatment like Botox. The advantage of skin resurfacing is that the result is essentially permanent and can produce a dramatic improvement. Finally, surgery is an option, often performed in conjunction with a brow lift. I do not typically try to remove the muscles that cause horizontal forehead lines because this can give an unnatural appearance and affect brow position. I do think that a brow lift can sometimes help to soften horizontal brow lines because the brow is no longer feeling heavy and needing to be lifting by the forehead (frontalis) muscles. Also, during a brow lift, the muscles between the eyebrows in the glabella area that cause frown lines or the vertical "11" lines can be weakened. This does not require any extra incisions or recovery time. Even when this is performed, it does not typically cause an improvement that is dramatic enough to no longer see benefits from Botox (meaning that some motion will typically return over time). Hopefully this is helpful. All the best,