One truly remarkable consequence of BOTOX ® administration that I have seen over and over again is the gradual complete disappearance of deep, vertical furrows between the eyebrows (frown or 'scowl' lines). With long-standing muscle contraction, the vertical lines between the brows may become actual physical clefts or grooves in the dermis, resulting in creases that are still apparent even when the skin is spread apart tightly with a finger on each side of the crease. In such instances, the initial BOTOX ® injection will soften but not completely eliminate the deep furrow. With regular BOTOX ® treatment, however, such that the frown muscles are never allowed to fully regain their normal ability to contract, the deep furrows may gradually fade completely.
Some patients with chronic, deep furrows between the brows achieve improvement but not complete correction of these creases with repeated BOTOX ® injection. In these cases, a soft tissue filler can be used to eliminate what remains of the furrow. I have used Restylane for this indication in a number of patients with excellent results, and for several of these patients I have performed structural fat grafting of the remaining furrow to provide a permanent correction.
Michael Law MD
Board Certified Plastic Surgeon
Raleigh, Plastic Surgeon
