Tissue Fillers for the Forehead and Bridge of Nose?

Thanks for the interesting question. I often have patients who ask me the very same thing during their skin consultations. The approach which I have found most helpful is to use Botox or Dysport for these deep horizontal forehead lines, vertical lines between the eyebrows, and nasal bridge lines ("bunny lines") first and then see the patient back in 1-2 weeks. At this point if there is a bit of a residual wrinkle, a small amount of a filler such as Restylane or Juvederm can be placed to fill it. Because these lines are related to muscle activity constantly folding the overlying skin, the best approach is to start with a neuromodulator such as Botox or Dysport to relax the muscles. The vast majority of the time, this single treatment is sufficient. 

Best,

Dr. Mehta

In the vast majority of patients with glabellar frown lines
and transverse nasal wrinkles, the treatment of choice is Botox.This product works by decreasing the ability
of the forehead muscles to contract.When strategically placed it can impact the glabellar muscles and
minimize vertical glabellar frown lines and transverse nasal lines.Unfortunately,
botox may not totally alleviate these frown lines when they are of long
standing duration and deeply etched into the forehead and nose.Under these circumstances, injectable fillers
may be effective in treating this problem.In most
cases we utilize hyaluronic acid fillers.These include Juvederm, Restylane and Perlane to name a few.These products typically last about 6 to 9
months.In patients who want more
permanent solutions we utilize Radiesse.All of these products are associated with excellent clinical results and
high levels of patient satisfaction.If
Botox hasn’t adequately addressed vertical glabellar frown lines and transverse
nasal lines, consultation with a specialist is appropriate.This specialist should be able to formulate a
treatment plan that uses injectable fillers to address this problem.

The line you describe on the bridge of the nose would most likely be suited for a combination of Botox and Restylane. In cases like yours, Botox can often not be enough to solve the issue and a dermal filler is used to provide volume to the skin in the crease at the same time that Botox works on relaxing the muscle.
We would not recommend using Restylane for the forehead lines and would recommend a surgery consultation instead.

Absolutely. They can achieve very good results. Botox is a helpful area for the bridge of the nose in addition to the filler. Sometimes the line is so fine that human collagen injections could give a finer result than the Juvederm or Restylane.

Fillers and botox are the best treatments for this area, but one without the other probably won't work all that well. Additionally, I would recommend Restylane over Juvederm as Restylane has a bit more effectiveness in this area. It will need to be repeated over time, but I find that it gets better as well and less injections are needed if you continue it.
One area that responds especially beautifully to fillers in this region is the 11 line, especially if it is deep. But, again, you need to use it with botox in order to gain full correction. And make sure you go to an expert (dermatologist, etc) who does their own injections. This area is very challenging and needs to be done by someone who isn't 'experimenting or learning' on you.

Hi Red Robin,
The lines that you describe are horizontal between the brows at the bridge of the nose best respond to Botox. Fillers can cause some very unnatural edema and swelling in that particular area.
The horizontal lines of the forehead are best treated with Botox. The vertical "11" lines between the eyebrows can be very well taken care of with a combination of Botox and hyaluronic acid filler.
Now Robin, keep on "bob-bob-bobin' along". Be well.
Dr. P

An experienced injector will have no problem injecting the bridge of the nose. The forehead lines will not be corrected by filler. Forehead lines are best treated by Botox or Dysport, as these products relax the muscles that create the lines.

Wrinkles on the nose are caused by the muscles under the skin.  These wrinkles have been called bunny lines.  One of my patients calls them her "cougar lines".  Whatever you call yours, they may be treated very effectively with Botox or Dysport.

If the the lines have been around for a long time, fillers like Restylane or Juvederm may be helpful to reverse the skin creasing.

It is important to place the fillers carefully to avoid injury to blood vessels in the area.

In summary, Botox or Dy sport, sometimes with fillers can erase those nose wrinkles away.  It helps to have an experienced injector treat you.

Lines in the forehead and the bridge of the nose are commonly treated first with Botox. This will help relax the muscles are the cause of these lines. However, if persistent wrinkles remain, they may be filled with the dermal fillers such as Juvederm or Restylane. Your best bet, is to receive Botox to these areas and determine what effect this injectable will create. If you have any residual lines they may be corrected with a filler.

Restylane can be quite helpful in treating the horizontal line at the bridge of the nose, but don't expect perfection.  The result will depend on the depth of the crease, the overall structure of the forehead/nose transition area, whether Botox is being used with Restylane, and the type of skin you have.  The best treatment for that line is a brow lift with excision of the procerus muscle, but that may be more than you are looking for.

I have had tremendous success with treating the "11" lines using Restylane.  Often times those lines are simply too deep for Botox alone.  Restylane plus Botox for those lines is usually very impressive and typically the Restylane need not be repeated for years if Botox is maintained.