Botox is the first like of defense in our office for this area. We usually have the patient come back in 10 days to evaluate the result. If the lines are very deep and have been there for a long time we might consider a filler. One must be very careful when this is done as there are, (fortunately), rare but possible complications.
Can Juvederm Ultra 3 Be Injected into the Glabella Lines?
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Two Pronged Approach.
The lines that develop in the glabellar region are caused by the corrugator facial muscles. These muscles are ideal for treating with Botox. However, if the lines are significantly deep enough, using a filler like Juvederm works quite well.
Not in US yet
This product has not been approved for use in the US. But we do have Juvederm Ultra XC or Juvederm Ultra Plus XC.
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Yes, Juvederm works very well in glabellar lines.
Juvederm works well with or without Botox in the glabellar lines. A skilled dermatologist or plastic surgeon understands how to safely perform these filler injecitions.
Fillers in Glabellar Creases...
Having a filler injected in the Glabellar creases is doable however, it is not FDA approved. It is done often if the creases are deep to help fill, as an "off label" use. I always recommend Botox injections on the same visit for best results and to help relax the muscles (the corrugators) that cause the verticle wrinkles.
Hope this helps.
Dr. Grant Stevens
Juvederm in the Glabella
Glabellar lines are caused by dermal atrophy from hyperactive muscles in this region. The best treatment is a combination of Botox and Juvederm for deep lines. You should first have Botox injected and observe the result for 2 weeks. If they lines do no completely resolve, then consider having Juvederm Ultra injected under the lines to help soften their appearance.
IMHO fillers should not be injected into the glabella
There are reported cases where fillers, injected into the Glabella, have pinched off the vein traveling in the glabella. This results in skin slough and scar formation in the center, of the forehead, the size of a quarter. Best, IMO, to use Botox in the Glabella for this reason.
Fillers for glabellar frown lines
I have abandoned fillers in the glabellar lines after seeing two patients complicated by intravascular embolization/occlusion/ischemia. The complication is extremely rare, but if you do enough injections, it happens. I prefer Botox for this area.
JuveDerm can certainly help glabellar lines.
In the US, we don't have JuveDerm 3 but rather similar products of JuveDerm Ultra and JuveDerm Ultra Plus. The data shows that the combination of Botox plus filler works better and longer than filler alone (study by Carruthers in Dermtologic Surgery with 18 weeks of Restylane durability in the glabella vs. 32 weeks of durability if Botox was used to pre-treat the area). So, Botox or Dysport can be very helpful if used first to reduced the movement of the area, and then filler placed about a week later. The filler than doesn;t have the muscles working across it, so work better. The important caveat is that the glabella has blood vessels (supratrochlear artery and dorsal nasal artery) that could be compromised with filler injections, so it is imperative that fillers be used very carefully. Use of a hyaluronic filler is recommended, as the enzyme hyaluronidase is then available to potentially be of assistance in the case of vascular compromise. For safety purposes, use of low filler volumes and considering a few treatment sessions with a hyaluronic filler is commonly recommended.
Juvederm in glabella
Juvederm can be injected in the glabella lines but I would recommend starting with Botox first. Botox will help soften the lines and prevent new ones from forming. I would recommend going to a doctor - facial plastic surgeon or dermatologist - who is experienced in injectables to perform either procedures - especially if you have Juvederm placed in the area. If not done correctly, there can be serious complications. Either way - Botox and Juvederm are both used routinely to correct these areas and I'm sure you will be very pleased with your results.
Dr. Cat Begovic M.D.
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