Ask a doctor

Will It Be a Better Effect on the Frown Lines if I Get Dysport to Forehead Too? (photo)

I have deep wrinkles between eyebrows (11's) I had dysport to glabellar area looks much better but I can still see these two wrinkles (in picuters u can hardly see them) ..will I get a better effect if I do the forhead too ?? I posted pics

Doctor Answers 6

You've had quite a nice result

I'm going to slightly disagree with Dr. Steinsapir on your results. I think you've had an excellent result with the botulinum toxin. Based on the photo I agree that the "head" of your eyebrow IS slightly lower than before, but DO NOT agree that the outcome is aesthetically unpleasing.

If anything, the "fuller brow" appearance you have in the last photo is a more youthful looking brow than your first photo [before botox]  . Honestly though, the two photos seem to be  taken from two different angles: your last photo seems to be taken from a higher angle so you are looking up into the camera. This has the effect of making the eyelids look slightly more open, and the eyelids/brow region more full. So a direct comparison is difficult.

I would agree with Dr. Steinsapir that you should be very careful with regards to treating the forehead with botox.  That WILL drop your brows, and will NOT have an effect on the "11's".

The comments on dynamic vs static  wrinkles are right on.  Botulinum toxin treats dynamic wrinkles very well, and can soften static wrinkles, but won't eradicate them completely. If you want further improvement of the static wrinkles, you could consider fillers.

Good luck

Seattle Oculoplastic Surgeon
5.0 out of 5 stars 30 reviews

Glabella looks fabulous

From the photos that you submitted, your results look great. By also doing your forehead, this may make you feel better about your 11's. One other option is to go back to the physician who treated you, and get their opinion on a touch up in that area. I certainly think from the picture that you got the results that were indicated. Take care

Jeffrey Adelglass, MD
Dallas Facial Plastic Surgeon
3.0 out of 5 stars 6 reviews

Frown lines and Forehead lines can be improved with Dysport

however, they are caused by two different sets of muscles.  Treating one area, usually does not improve the other, although there are some minor exceptions.  Most patients need to keep some forehead movement because their eyebrows are too low set, and relaxing the forehead would make the brows seem "heavy".  Some patients have lines on their frown, even when they are not moving the muscles.  These will slowly improve with Dysport treatment but can be improved faster with the use of Restylane at the same time as Dysport, to fill in the lines.  Best to you.  Dr. Jacob

Carolyn Jacob, MD
Chicago Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

First, this is a very nice cosmetic botulinum toxin treatment.

Our brains are goofy.  We never are satisfied.  So here you have had a very nice improvement but the question you are asking is how to make this better!

In looking at the before and after photos, you have nice improvement in the glabellar area at the price of brow position.  You eyebrows have relaxed into the brow space (i.e. the eyebrows are now sitting lower encroaching into the upper eyelid space.  You do have a couple of lines on the forehead.  Is it worth eliminating these forehead lines with more treatment?  The price is paralysis of the forehead.  The frontalis muscle in the main eyebrow elevator.  More treatment of this muscle means loss of forehead movement which creates the frozen look.  Look at my website and read about Microdroplet botulinum toxin treatment (lidlift dot com).  I have a patented method that isolates treatment to just the eyebrow depressors rather than treating the forehead elevator.  This gives you lift without freezing the forehead.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 20 reviews

11 lines

11 lines can be both static (meaning they are present even when the muscles aren't moving) or dynamic (meaning they are worse, or only there when the muscles are moving). Dysport and Botox only work on dynamic lines. They soften these lines as they make it so the muscles can't contract and form these lines anymore. If you have static lines, those cannot be affected by Dysport or Botox no matter how much you put in or where it is injected. If you just did the treatment for the first time, I'd give it some time to see if those lines will soften a bit more on their own and be less obvious, but if they don't and you still have these static 11 lines, the only way to treat them is to put filler in them.

Frown line options

Thank you for your question. The frown lines between the brows can be address two different ways:
1) Botox or Dysport can be used to soften the deepening of the frown lines when making a frown expression. The treatment may even soften the lines that are present at rest. The effects typically last 3-4 months depending on the dose. I generally use between 15-40 units of Botox (30-120 units of Dysport) in the frown area depending on the strength of the muscle and the degree of frown reduction we are trying to achieve. 
2) Restylane or Juvederm can be used to soften the frown lines that are present even when you don't make an expression. This can last for a year or more when used in conjunction with Botox.
For someone who has concerns with both the static lines (without expression) and the dynamic lines (with expression), then using both products would work well together. 
I often find that patients who return after a Botox or Dysport treatment in the frown areas complaining it didn't work, is due to the confusion between the static and dynamic frown lines. They continue to see the static lines even though the dynamic lines have softened considerably. 

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.