I have deep lines between brows. Will Perlane help to fill in lines?
Perlane on Glabellar Lines?
Doctor Answers (8)
If the blood vessels of this area are embolized, skin could die or worse. Many fine doctors will not even inject this area at all.
If you do have injections, your surgeon or dermatoligist should have great experience, a good artistic eye and a conservative attitude.
Perlane to deep glabella lines
Using caution in this area is recommended due to the vascularity of the area, and consulting with a reputable and experienced practitioner will help you make the correct decision!
Glabella and fillers
There have been concerns about using filler product in the glabella region, but I have used it on occasion and it works rather nicely.
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Beware of Filler Injections In The Glabella
Filler injections in the glabella have been reported to result in death of teh skin overlying the area that is injected. While it can be safely done in the area, any physician who performs filler injections into the glabella should have a protocol ready in case this complication is encountered.
Perlane in frown lines
While I generally agree that you need to be careful when injecting this area, I do not agree with the objections to the use of Perlane. If your doctor is not comfortable injecting the glabellar lines than he/she should simply not inject them. The risks that have been reported relate to small arteries that run near this area. If those arteries are injected there can be serious side effects. The arteries being talked about run under the skin in the subcutaneous tissue (fat). The injections in this area should be placed in the deep dermis and not where the arteries run.
As for the choice of filler material, Restylane works well for thinner skin or more shallow lines. Generally, if I have a female patient with these lines I would likely prefer Restylane. In my male patients who usually have thicker skin and deeper lines I find Perlane to be very effective. Its a thicker product and lasts longer. You should only be treated by a doctor with experience and comfort in treating this area with fillers. I would recommend that you have consultations with a few plastic surgeons certified by the American Board of Plastic Surgery. You can make a play together that meets your needs.
I hope this info helps!
Recent consensus recommendations re: Perlane use on glabellar lines
The most recent supplement to Plastic and Reconstructive Surgey discusses the consensus recommendations on this topic.
Perlane is not mentioned as a recommended treatment for the glabellar lines. However, Restylane and Perlane are mentioned and specific recommended volumes are discussed. Combination use with Botox is also discussed to increase the duration of hyaluronic acid filler effect.
The concerns expressed by the other responders to this question are also addressed.
No Perlane in the glabella
I agree with the other physicians. Perlane is much too thick and should never be used in the glabellar area for filling.
This area is best treated with Botox as the first measure. If the lines are significant and cannot be totally erased with Botox injections, then in some cases, a filler may be used. Typically, I use only Restylane or Juvederm in these areas and the treatments are extremely conservative.
As stated previously, you have to be careful in this area because of the relatively superficial blood supply that, if compromised, could result in skin necrosis and scar formation.
FIller injections in the glabellar area should only be performed by very experienced injectors who are very familiar with the vascular anatomy of the face.
This is a high risk area for fillers. They can be used here but only with care and with a filler that should be placed superficially. Perlane is a filler that is meant to be placed in the deep dermis-upper subcutaneous region and is absolutely not a superficial filler.
This area can be dangerous for a filler placement, since gangrene can result if the filler is not placed properly , either the wrong filler ( eg. Perlane), or placed too deeply or rapidly. What happens is the vasculature is compromised. I know of this happening when an unfortunate victim sought treatment at a so-called medi-spa where a lay person performed the injection. This underlines what many of my colleagues on this site preach: that these procedures should be done by board certified plastic surgeons, dermatologists or opthamologists.