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Is It Possible to Use Restylane Only for Frown Lines? Not Botox?

I've had the misfortune of having a permanent frown line between my eyebrows - when frowning AND relaxing - since the age of 22. Seven years later I finally decided to try botox, and had an injection four days ago. While I enjoy seeing my smooth brow, the injection has not completely erased the frown line, and I don't like my stiff, funny expression when I try to raise my eyebrows and only the edges are elevated. When the botox has worn off, can I get an effect from restylane only?

Doctor Answers 14

Botox or restylane for frown lines

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.
2) Restylane or Juvederm can be used to soften the frown lines that are present even when you don't make an expression.
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.

Botox and filler work differently for frown lines between the eyebrows

Botox keeps your corrugator muscles from making the frown line. It sounds like you got a good result at rest.  However, you may have gotten a "spock effect." Revisit your injector and tell her your complaint.  A touchup may help to take away your "stiff-funny" expression.  

Restylane fills in furroughs.  It will take away the line at rest, but it will not keep your muscles from making a frowning face when you are concentrating/angry/etc.  

Restylane and botox actually work very well together for the frown line between the eyebrows.  If you want to pursue restylane, make sure you go to an experienced injector.  The reason is that the frown line is an advanced area; sometimes tissue necrosis can occur in that area so you definitely want to go to someone with experience.

Only for Frown Lines?

While restylane can be injected by itself for frown lines, botox is the treatment of first choice for frown lines. Restylane is sometimes used in combination for deeper lines. This treatment should only be done by an experienced and expert injector due to the risks.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 27 reviews

Yes, Restylane only for a glabellar line works, BUT..reconsider the Botox pattern.

Sounds like you did have some significant Botox placement in your forehead area, but if you had it placed JUST for the vertical frown line between your brows, it should not affect the raising of the eyebrows at all (causing that outer winging), IF done properly.

Fillers like Restylane and Juvederm for sure can be done alone, and there is no problem with that, except that the effect is not as long lasting since you re-crease the area multiple times a day and push the filler away. I would recommend reviewing what Botox was placed where, and considering (next round.... in 3 or 4 months) repeating some Botox but in a different pattern with none on the forehead itself, along WITH your filler.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
5.0 out of 5 stars 42 reviews

Can I use just Restylane or Juvederm for frown lines?

Hi Ang.  While it is possible to use just Restylane or Juvederm for this area, we do not inject fillers until after we have injected Botox.  In many cases the frown lines resolve and no fillers are needed.  In other cases, we do need the filler, but much less so than before the Botox.  We would suggest trying the Botox first.

See the pictures for the deep frown line at the link below.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Botox vs. Juvederm or Restylane for forehead lines

Fillers do not work as well as botox for feadhead lines because as the muscle continues to move the skin continues to crease when Juvederm or Restylane are used but botox makes the skin muscles relax.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
5.0 out of 5 stars 34 reviews

Restylane for the Medial Brow Frown Lines

Restylane or Juvederm can work in this area.....but I caution you to have someone who understands the anatomy well.

The supra-orbital vein, artery and nerve are near the injection site.  Make sure that you have someone who understands this anatomy well. 

it is important to remember that the mechanism of how Bo-tox works is by relaxing the muscles at the muscle nerve junction.  If a frown line has been present for many years it may take a number of injections over time to relax the muscle and have an effect.  If there is loss of dermal tissue, one may never have a perfect result.

Cynthia Boxrud, MD
Santa Monica Oculoplastic Surgeon
5.0 out of 5 stars 5 reviews

Is It Possible to Use Restylane Only for Frown Lines? Not Botox?

Sure but the muscle action can still cause the eleven's. Botox paralyzes vs Restylane fills furrows. Discuss in detail with your chosen injector. From MIAMI Dr. Darryl J. Blinski, 305 598 0091

Frown lines

Usually frown lines are treated best with either botox or dysport.   Fillers can help in some regions but an exam would be necessary to assess this.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 22 reviews

Botox vs. Restylane for Frown Lines

When is comes to frown lines, Botox works better for most people. It is possible to reduce the frown lines without dramatically affecting the ability to raise the eyebrows. Eyebrow motion is affected with reduction of the transverse forehead wrinkles because both depend on the motion of the frontalis muscle. The frown lines are caused by a different muscle and with careful use, you should be able to relieve your frown lines and maintain eyebrow elevation.

I most often use Restylane in this are when the frown lines are too deep to resolve with just Botox, but I do use it occasionally for patients who don't want Botox.  Since Restylane works by adding volume, the correction must be precise, and there is an upper limit to the amount of Restylane that can be added without causing unwanted glabellar fullness.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 10 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.