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Which Product Do I Use for Vertical Lines? Botox or Restylane?

I have two sort of deep vertical lines right between my eye brows. Which procedure would be better, botox or restylane. Or should one have both procedures on the same site? I am not sure if you can see the vertical line on my picture. I am the one on the right. Thanks.

Doctor Answers (22)

Get Botox first


Most physicians would agree that Botox is the treatment of choice for your “11” and if the lines improve only partially, then you can consider having a filler injected. Be certain that you see a qualified experienced physician as there is a risk if too thin a filler is injected into that area. The safer ones to use are Juvederm and Restylane. Try the Botox first. Realize that the lines are there from years of frowning and the skin developed these creases from the accordion-like motion of the underlying muscles. Once the muscle stops moving and you don’t frown, it will take time for the skin to lose its crease.

The Botox will take a couple of weeks to reach its effect and may last for several months. Don’t rush in for a filler until you give it a while; otherwise you might be spending more money than needed. On the other hand, if you have a reason to reduce the line quickly, such as an important social engagement or photograph shoot, I would still do Botox after the filler, but don’t do the filler just a few days before the event in case you bruise.

Manhattan Dermatologist
5.0 out of 5 stars 33 reviews

Botox for corrugator muscle lines



Thanks for providing the photo to help our answers. I think the active muscle lines between the eyebrows (corrugator muscle lines) would be ideal for Botox. In fact, that is the area for which the parent company obtained FDA approval for the marketing of Botox. Many of the initial studies were done for that area.

If you did not achieve satisfactory improvement after 2 treatments and 6-8 months time, you might add a filler in addition to Botox. I would not suggest filler alone. Good luck. I think you'll look great.

Sutton Graham II, MD
Greenville Plastic Surgeon
4.5 out of 5 stars 2 reviews

Botox first for glabellar frown lines


These are the corrugator muscles - when they contract, they form what we call 'glabellar frown lines', these vertical lines of wrinkles. The thing to do is to relax these muscles with Botox. Start there and see what it looks like before you pay for any fillers. Good luck. It should cost somewhere between 250-400 dollars depending on how prominent these muscles are in your case.

Hratch Karamanoukian, MD, FACS
Buffalo General Surgeon
5.0 out of 5 stars 8 reviews

Botox versus Restylane for vertical lines

I usually suggest my patients try Botox in this area first, since Botox usually provides good results.  Fillers also have a role in filling deep furrows between the eyebrows but I usually reserve them for patients who want additional improvement after trying Botox.  

William Andrade, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 13 reviews

Botox is great

If your wrinkles are only there when you make a facial expression, like frowning, then Botox would be good. If the wrinkles are there permanently, even when your face is neutral then restylane would do the trick. Some deeper creases can be treated with both. Either way, make sure you do the Botox first.

Michael Constantin Gartner, DO
Paramus Plastic Surgeon
4.5 out of 5 stars 60 reviews

Botox and Restylane


Botox stops the movement of the muscles causing your frown.  Restylane fills in the depressions.  You can have both the same day and if you keep up with regular Botox injections, your Restylane may last for years.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 17 reviews

Vertical lines on forehead requires Botox or Dysport first


Vertical lines on forehead are due to combination of dynamic and static wrinkles. I would consider Botox or Dysport first for dynamic lines which are caused by involuntary muscle contraction then followed by judicious placement of filler if necessary for the static lines due to loss of volume in affected area.

William Ting, MD
Bay Area Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

Botox/Dysport and Restylane/Juvederm can be a great combo!


For the vertical frown lines between the eyebrows, the combination of Botox AND filler can work better together than either alone. The Botox works to weaken the muscles creating the wrinkle, and the filler works to immediately lift and smooth the line that would otherwise take months and months and months to smooth out just with Botox alone preventing creasing.

If the line is mild, and your budget has limits (whose doesn't?), it's a good plan to try the Botox first and see after a round or two if the line is smooth enough. If not, then add filler.

Starting with filler alone is an option (especially for someone nervous about Botox) but it's important to know that the gel filler will physically lift the line but NOT stop the muscles from continuing to try to crease that skin, ultimately leading to a deeper line and the need for more filler sooner than if Botox were there too.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.5 out of 5 stars 40 reviews

Frown lines and treatment


For the vertical glabellar lines or frown lines I usually start off with Botox. If they are very etched in, I will add a filler after I see the affects of the Botox.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Botox is the First Choice for Frown Lines


It looks like in your picture that you would be better suited for Botox. While the lines may seem deep, they look like they would be effectively addressed with Botox and that it would not be necessary to use Restylane.

We only suggest Restylane in this situation if Botox has failed to do the job of smoothing the area.

Try Botox first and if there are still some wrinkles left, then try Restylane. Make sure you choose your practitioner based on his/her experience with these procedures before starting.

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