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Dermal Filler Without Botox - for Frown Lines?

I have a single, static frown line between my brows at rest. I do not frown during the day, and wear tape over the lines at night to prevent me frowning as I sleep. I understand I will need a dermal filler to plump out the folded skin. My question is, in my case, what is the point of having Botox as well as the Dermal filler? It seems like Botox will be a waste.

Doctor Answers (16)

Here's why you need the Botox too.

+3

Even though you have a static wrinkle and wear the tape at night, the reason the wrinkle formed in the first place is because of the muscle movement.  Most people have a baseline muscle tension or contraction that they are not aware of that makes them furrow if they have a a wrinkle that you are describing.  While the filler sounds like what you need to make the crease go away at this point, the Botox will keep it from coming back more quickly. Over time it may prevent you from needing fill at all, as stopping the muscle is really getting to the root of the problem.

Hope that helps explain the rationale!


Sonoma Valley Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Combining Botox and filler for frown lines

+3

In my experience, superficial lines at rest in the glabellar area will disappear over time if you keep the area tightly controlled with frequent Botox or Dysport injections at appropriate doses. This typically means injecting the area every three to four months to keep the muscles as quiet as possible. I typically reserve the combination of Botox or Dysport with filler injections for deeper lines or for someone who is in a hurry for the lines to disappear for a special event.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

Dermal filler or Botox for static line on forehead

+3

Often a combination is suggested because: If the line is worse when you move the muscle, then Botox will stop you from being able to do this (i.e., stop the dynamic movement that's creating the static line). Then you have the static line filled in (please visit a good, board-certified injector for this as facial anatomy in this area is key!).

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.5 out of 5 stars 8 reviews

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Botox and fillers are a great combo for s

+3

Adding Botox to that area will help to diminish the line. There are muscles on either side of the line that push the skin together.  Botox is usually my first choice, adding filler only if the line is too deep to be overcome by Botox alone. 

Jennifer Parker Porter, MD
Chevy Chase Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Dermal filler and botox

+3

these work synergistically in the right patients. Botox will correct the underlying dynamic muscle movement and filler , if appropriate will elevate the folded frown line skin. The treatment of choice for glabella lines is botox with dermal filler used secondarily.

Dominic Bray, MBBS, FRCS
London Facial Plastic Surgeon
5.0 out of 5 stars 41 reviews

Botox will extend the life of your dermal filler.

+1

At this point, you definitely need a dermal filler to plump out the crease across your forehead. However, that crease was etched in your skin by ongoing muscle contractions of which you’re likely unaware. It is this constant movement – while awake and asleep – that causes the furrow. So if you merely fill it up, without restricting the muscle movement, the furrow will only return and deepen. Botox injections every 3-5 months will keep your brow smoother longer and reduce the severity of the line when it starts to reappear. That, in turn, will make less filler necessary.

Hal Michael Bass, MD
Pembroke Pines Plastic Surgeon
4.5 out of 5 stars 30 reviews

Filler in glabellar area

+1

Lines in the glabella (between the eyebrows) are caused by movement.  A neurotoxin, such as Botox, Dysport, or Xeomin is almost always indicated in this area to relax lines.  Occasionally, lines can be so deep that they are present even after the neurotoxin is working.  In this case, an additional superficial injection of a hyaluronic acid (juvederm, restylane, or belotero) can be a good choice.  This is an off-label injection that should be performed by an experienced cosmetic dermatologist or plastic surgeon.  There are risks when injecting filler in this location, which should be discussed prior to treatment.   

Donna Bilu Martin, MD
Miami Beach Dermatologist

Depends On The Wrinkle byVillar

+1

Frown lines develop from muscle contraction whether you are aware of it or not. Before Botox, we would fill the lines with filler, but the muscle action would tend to force the filler out.  After Botox, we paralyze the muscle first and inject the filler a week later if convenient in a perfect world.

If the wrinkle is soft and pliable in the early stages, a filler may work very well.  If the wrinkle is very deep etched, save your money.  Fillers are disappointing, but the Botox may prevent it from worsening.

Luis Villar, MD
West Palm Beach Plastic Surgeon
5.0 out of 5 stars 6 reviews

Botox and Dermal Filler for Glabella Frown Line

+1

A dermal filler can fill the line, and, if put in the dermis beside the line, stiffen the area so that another line does not form readily there. However, the filler does not address the underlying cause of the line which is function of the muscle below it. Even if you do not think you frown during the day, you do. The tape you place at night also will not keep the muscle from working and the skin from wrinkling. The only thing that has been shown to prevent the lines from forming is Botox. Therefore, the main treatment for these lines is Botox. If, when you are relaxed, you have no lines, then you need nothing else. However, if you have an indelible line that does not go away when you are relaxed, you need the filler

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

Dermal filler without Botox

+1

The frown line has been caused by movement.  If you feel you no longer frown, you can try only filler and see if you like the result and how long it lasts.  If you continue to frown, the filler may only last a few months.  With Botox maintenance treatments, the filler may last indefinitely.  Please see an experienced dermatologist or plastic surgeon for the treatment.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.