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Do New Wrinkles Require Dermal Fillers or Just Botox?

I am in my mid-30s and have just noticed some new wrinkles on my forehead as I tend to raise my eyebrows a lot. If they are new, slight wrinkles and not deep do you think I will need a filler or should Botox be enough?

Asked 44 months ago by ElleW
Sort 27 expert answers by:
+1

Botox for forehead wrinkles

The question of whether to use Botox or dermal fillers is one that is based on the area of the face being treated and whether or not the wrinkles are related to muscle action. Because Botox will relax the muscles that cause these forehead lines, it is the correct choice for this area. Dermal fillers would not be appropriate.
Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
+2

Forehead wrinkles and Botox: Recommendations for treatment

Transverse (Horizontal) forehead wrinkles are treated with Botox injection with excellent results. Botox is a superior product for erasing transverse lines on the forehead. The clinical efficacy of Botox is far superior to fillers in this area My recommendation would be to undergo Botox first and then determine if you need additional treatment with more Botox or fillers.
Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon
+2

If gentle manipulation erases the offending wrinkle, Botox is your treatment

One quick trick to try is identify if you can delicate smooth out the wrinkles completely between your fingers. If gentle pressure is all it takes Botox will provide complete correction. Those individuals with deeper lines that cannot be gently cooerced into receding typically benefit from both Botox and filler. Based on your description at this early stage you will likely find that a lovely response is obtained with Botox only.
Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon
+2

If they are not there at rest, Botox is all you need

When you have totally relaxed the muscles, if the wrinkles are absent then Botox is all you need. After years of practicing making the wrinkles, the skin folds preferentially like an accordion. In these people, even when the muscles are relaxed, there are still lines on the face. These people also need a dermal filler.
Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
+2

Botox will work for you

Based on your age and description of the culprit wrinkles, Botox should provide you with very satisfying results. It is very important that the injections are at least one centimeter above your brow line so that you maintain natural brow movement and expression while improving the forehead wrinkles. Botox is indeed known to be preventative, however in my opinion this occurs more frequently with the crow's feet wrinkles (side of the eyes) and glabellar area (between the eyebrows). The... more
Kamran Jafri, MD
New York Facial Plastic Surgeon
+2

Botox for lines of Movement

We all get wrinkles for various reasons. The ones that tend to dramatically worsen over time are usually caused by muscle movements and these are amenable to Botox. Botox softens the muscle contractions and shifts the stress from muscle movement to other areas preventing the constant wrinkling in the same spots. Botox can be used on the forehead lines, the frown lines between the eyes, the wrinkle lines on the nose, around the lips if done carefully, around the eyes for crow's feet. Some... more
Edgar Franklin Fincher, MD, PhD
Beverly Hills Dermatologic Surgeon
+1

Botox best for forehead expression lines

The lines in your forehead are a result of the forehead muscles contracting and thereby wrinkling the skin. Botox (or Dysport) is the first line of defense against these sort of "active" wrinkle lines. The only time I use filler for these types of lines/wrinkles is when even after Botox, the lines are so etched in, that a filler can serve as the finishing touches in smoothing out the etched in lines and wrinkles.   Hope this helps! Dr. Y
Haresh Yalamanchili, MD
Houston Facial Plastic Surgeon
+1

Botulinum is best!

Dynamic wrinkles in the forehead are best treated with botulinum injections (Botox or Dysport) and you are the perfect age for obtaining wonderful benefits from this treatment.  Just about 6 injections with a tiny needle will smooth your forehead and relax those lines that concern you.  Talk with either your plastic surgeon or dermatologist about this and you'll soon find how safe, effective, and ideal this treatment is.  Enjoy! 
Randolph Capone, MD
Baltimore Facial Plastic Surgeon
+1

Botox only For New Wrinkles

Hi, It sounds like you are the perfect patient to start Botox!  If you are young and only see the wrinkles with dynamic movement, you are the best canidate Botox for wrinkle prevention.  If the wrinkles are there at rest, then Botox will help soften them by preventing the muscle from further contraction, but you do need a filler to fill out the crease.  Botox as wrinkle prevention for forehead lines, frown lines, and crows feet along with sunscreen is a fantastic... more
Grace Liu, MD
Newport Beach Dermatologic Surgeon
+1

Botox should be enough to prevent new wrinkles from deepening.

If forehead lines are new and caused by facial expressions, Botox alone should be enough to soften the activity of the muscles and allow the lines to reverse. If they are long standing, deep folds, a filler at the same time can be synergistically helpful to smooth sooner and hold longer.
Jessica J. Krant, MD, MPH
Manhattan Dermatologic Surgeon
+1

Botox for forehead wrinkles

Botox or Dysport is what you need for forehead wrinkles. Botox helps the muscles relax in the forehead and the lines will diminish. Botox or Dysport lasts 3 to 4 months. If Botox doesn't help with wrinkles in forehead than that's when a filler will help. 
Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
+1

Yes it works

Botox is a perfect solution.  Wrinkles in the forehead are caused by repeated facial expressions, such as continued use of the frontalis muscle when raising your eyebrows.  Botox works in paralyzing the muscle so that the movement is either decreased or stopped completely leading to resolution of the wrinkles.  Fillers, such as Juvederm, work better in deeper lines such as the nasolabial folds.  Best wishes, Neil Zemmel, MD
Neil J. Zemmel, MD
Richmond Plastic Surgeon
+1

Early Wrinkles Treated Well With Botox

In fact, the best time to start treating forehead and glabella (area between the eyebrows) creases is before you get them.  Botox (and Dysport) protect the skin and allow it to repair itself by stopping the damage caused by the day-in and day-out "scrunching" of the skin by muscles.  Once the damage is done the skin is never quite as good as it could have been had the skin been kept wrinkle free from the beginning.  I put Botox/Dysport into the same mindset as... more
Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
+1

Multi-prong approach best for facial lines

Multifactorial approach is typically the best one for lines on face. For forehead wrinkles, excessive and involuntary muscles are to blaim, thus Botox or Dysport injection should be enough. For glabella, the area between eyebrows, both botulinum and fillers can be used in combination, typically fillers first followed by Botox or Dysport as you need to minimize manipulation of botulinum tox injected areas for 24 hours to minimize migration.
William Ting, MD
Bay Area Dermatologic Surgeon
+1

Botox and Restylane used together

Botox is good for wrinkles caused by movement. In general, Botox works well in the upper third of your face. Wrinkles in the forehead, eyebrows, and the sides of the eyes. Dermal fillers are better for indentations and sunken areas - under the eyes, in the cheeks, and the corners of the mouth. Botox and Fillers work very will together. In severe cases of wrinkles in the area between the eyebrows called glabella, Botox is typically used first. If grooves are still present after... more
David Mabrie, MD
Bay Area Facial Plastic Surgeon
+1

Botox and Forehead Wrinkles

Lines on the forehead usually begin in the early to mid thirties and are caused by movement of the forehead muscle. If these are mild or fine lines then Botox alone can treat these adequately. However, since the forehead muscle also raises the brow, completely relaxing this muscle with Botox can lower the brow somewhat. I recommend starting with a small dose of Botox in the forehead and have you come back in 1-2 weeks to see if that's enough and if not, we give a bit... more
Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
+1

Forehead wrinkles

I think it is always better to try using Botox on forehad wrinkles first to see how they respond.  A filler can always be added but cautiously.
Steven Wallach, MD
Manhattan Plastic Surgeon
+1

Botox terrific for wrinkles on forehead

  Botox is a molecule that is injected around muscles to help relax them. Wrinkles and lines in the forehead are caused by muscle contraction. For this reason Botox is an ideal treatment to help relax these forehead muscles and erase the overlying wrinkles. If the wrinkles remain untreated they may lead to permanent changes in the skin and very deep wrinkles. In these cases the Botox alone may not be raced the wrinkles for deep wrinkles or lines between the eyebrows your surgeon may... more
B. Pat Pazmino, MD
Miami Plastic Surgeon
+1

New wrinkles on the Forehead

It sounds like Botox or Dysport would be just what you need to keep those lines from getting deeper.  Fillers would only be appropriate if the lines started deep and once the neurotoxin take affect were still evident.  Besides Botox however, I would recommend a good sunscreen and moisturizer.  It is much better to prevent the fine lines and wrinkles then to try to treat them once they have formed. 
Michael L. Workman, MD
Portland Plastic Surgeon
+1

NEW forehead wrinkles

Botox is THE answer. Make sure your treating physician understands you wishes and cosmetic ideals though. In the very unlikely event that Botox fails to completely cortrect this issue, only then I would recommend you try a wrinkle filler such as Restylane/Perlane or Juvederm. Good Luck.
Peter A. Aldea, MD
Memphis Plastic Surgeon
+1

Choice of Botox or dermal fillers depends on location & cause of wrinkles

It depends on the location and underlying reason the wrinkle formed. Botulinum toxin reduces the expression lines/facial wrinkles, whereas dermal fillers enhance tissue volume to fill in expression lines/facial wrinkles. Botulinum toxin and dermal fillers can play complementary roles and, in some situations, both may be appropriate.
Brian Biesman, MD
Nashville Oculoplastic Surgeon
+1

Botox is great for dynamic wrinkles or to prevent static wrinkles

Botox is wonderful for minimizing dynamic wrinkles that occur with muscle contraction. If you don't have the wrinkles while at rest and not contracting any muscles, then it likely will work well. There are instances when someone needs both Botox and a dermal filler, especially in the glabellar area between the eyebrows (the '11' sign) when these have become deep grooves.
Sanjay Grover MD
Orange County Plastic Surgeon
+1

Botox for wrinkles caused by muscle contraction

Thanks for the question. It sounds like your wrinkles are caused by muscle contraction. These wrinkles are perfect for Botox. Botox injections begin to work after 2-3 days. You'll notice an immediate improvement at that point. Even deeper wrinkles will soften over time. Find a board certified plastic surgeon or dermatologist to discuss your case with. I hope this helps.
Steven H. Williams, MD
San Francisco Plastic Surgeon
+1

Start Botox Early to Prevent Deeper Wrinkles

Wrinkles are caused by bending and folding of the skin in response to the underlying muscles contracting. With repeated folding over years the collagen in the dermis atrophies (thins) and a static wrinkle is formed - leaving wrinkles even when the muscle is not contracted. By starting Botox early, you prevent the years of strain on the skin which leads to deep wrinkles. Botox works by paralyzing the underlying muscles, which prevents the muscle from contracting and folding or bunching up... more
David Shafer, MD
New York Plastic Surgeon
+1

Botox might be the treatment of choice

In my opinion, Botox might be the treatment of choice for the forehead. At your young age it should give you a very nice result. Fillers often create a beaded appearance in these creases, especially if the muscle moves a lot without Botox treatment. Sometimes the vertical lines between the eyebrows are treated with both Botox and fillers if the lines have been there for a long time.
Ronald Shelton, MD
Manhattan Dermatologist
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