Botox or Laser on Deep, Vertical Forehead Creases?

Deep wrinkles on the forehead do require multiple treatment modalities. I would first start off with Botox, maximizing the amount on the forehead. Botox , or even Dysport, will relax the muscles and smooth out the lines, however they will not completely eliminate them. After 2 weeks, I will re-evaluate again. I love the fractional CO2 laser and I typically do it 2 weeks after Botox injection. The CO2 will help but do not completely remove the lines either. 6 weeks after the fractional CO2, I... more

 I've been using Botox for over 20 years and have done many Laser Skin resurfacing.  Botox is easy, safe and highly effective at reducing forehead lines and wrinkles without the recovery and healing time that a deep Laser skin resurfacing may have.  Why not try the Botox first and see if you're happy.

It’s hard to imagine your condition without seeing a photo. Normally, if the forehead creases are related to motion of the underlying muscle, then laser won’t help much as the lines come back as you continue to move the muscle despite the smoother skin surface from laser. Botox would help in this situation but , the areas of insertion needed to improve your lines might involve areas we normally don’t inject so as to avoid producing an unwanted droop. A filler might be a... more

I'd love to see a picture, but when someone has very deep and etched lines, Botox, then fractional CO2 2 weeks later, then filler like Restylane or Juvederm about 3 months later can be the trifecta of non-surgical shaping , smoothing and rejuvenating. Of course, I'd need to see your skin type and get a good history to make a recommendation for your unique needs.

I would suggest Botox either at the same time or preferably followed 2 weeks later by hyaluronic acid filler (Restylane or Juvederm).  The Botox is for the "dynamic" component of the wrinkles (with movement) and the filler is for the "static" component (wrinkles at rest). Good luck.

Botox would likely be the better choice (especially if the creases are between the eyebrows). You may also be a great candidate for a brow lift, which will take care of the problem long term. The vertical wrinkles are due to muscle pull (dynamic wrinkles), while laser is better at treating static wrinkles (wrinkles not associated with muscle pull). You may ultimately benefit from all of the modalities, but would recommend Botox and possibly brow lift. sek

These vertical creases can be somewhat more complex and difficult to treat than transverse or horizontal creases. Many times we will start with Botox and then determine whether Juvederm or Restylane injections might be required as well. Use of a Carbon Dioxide Laser may be helpful but only if the more non-invasive steps do not satisfy the patient.