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

asked 3 years ago by texasmom in Corpus Christi, TX
Latest answer by William Ting, MD
Question viewed 6,232 times
Tags: between eyebrows, eyebrows, forehead, comparison, furrow

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.

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

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... more

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

www.celibre.com

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... more

Ronald Shelton, MD
Manhattan Dermatologist

Botox for corrugator muscle lines

Texasmom: 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... more

Sutton Graham II, MD
Greenville Plastic Surgeon

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
Buffalo General Surgeon

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

Botox, Dysport, Wrinkle Treatment, Beverly Hills Botox Dysport, Los Angeles Botox Dysport

For lines between the eyebrows, called the Glabellar area, Botox or Dysport is superior to fillers. Fillers can cause pressure on the thin walled vein traveling along the same pathway as the lines in this area. If the vein is partially collapsed by the filler, the lack of blood supply can and has caused a quarter-sized hole in the center of the forehead. I have always considered fillers in the glabella to be contraindicated for that very reason. You can always contact... more

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

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... more

Jessica J. Krant, MD, MPH
Manhattan Dermatologic Surgeon

www.ArtofDermatology.com

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

Botox mostly

Probably the best procedure would be to adminster Botox. These are dynamic lines and respond to Botox (treatment of these lines, the glabella lines, are still the only cosmetic approval for Botox). Two weeks later you could come back to the office and see whether Restylane might be needed to fill in the slight more superficial lines that remain.An alternative is to have the fillers plased first and then have Botox injected ( in this order so the Botox does not obliterate the lines). ... more

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Both would do the trick - I would start with Botox

Judging by your picture, I think you would do great by starting with Botox as the first line of therapy. Botox would work to soften the vertical lines, and may or may not eliminate them completely. Over time, with repeated injections of Botox, any permanent creases that you have in the area may soften to a point that you are very pleased with the results. If not, certain fillers, such as Restylane or Juvederm, can be injected by a physician with experience injecting specifically in... more

Arash Akhavan, M.D.
Manhattan Dermatologic Surgeon

Botox and Restylane work best together for vertical forehead lines

Hi Texas Mom, You look great in your picture. Have Botox to treat the vertical "11" lines, and then have either Restylane or Juviderm injected directly into the lines. The filler can be placed either at the same time, or about one week after the Botox. You will find that even when the Botox wears off, the deep vertical lines should not return. In this area there is a "the sum of the treatments is greater than the individual parts" effect. My experience is that most... more

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Botox for the vertical lines

Texas Mom, If your a gambler you got that one. Thank you for identifying yourself in the picture. Your daughter could pass for a slightly younger friend, seriously. On closer inspection of the photo I did appreciate the vertical lines (11). The appearance of these lines is the result of decades of facial animation and emotion expression. Yours do not appear to be all that deep, so there's hope. I would recommend a trial of Botox only for your first treatment. If you maintain yourself with... more

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

You just need Botox

To texasmom, Hi! Your lines do not look "etched". You have a youthful face ant the "glabellar" lines are not very deep. 25 units of Botox injected in a flattened V pattern between your eyebrows will do the trick.

George J. Beraka, MD
Manhattan Plastic Surgeon

Botox, and maybe filler too

Botox will address the "dynamic" wrinkles that occur with muscle movement but not the "static" wrinkle in that location. Fillers, e.g. Juvederm or Restylane can be injected to that vertical line to fill it in. If you do not lapse in your Botox injections, eventually the "static" vertical line will iron itself out after a few months. Botox and filler can be administered to this location at the same time for convenience, but ideally you would have Botox... more

Bryan K. Chen, MD
San Diego Dermatologist

Botox is the choice for frown lines, use fillers if the Botox effect is incomplete

Botox weakens the contrraction of the frown muscles called the Corrugator and Procerus muscles. These muscles cause the lines, so when they are weakened, they contract less and the frown lines disappear. Fillers, like Restylane, Juvederm, Radiesse, Perlane, Sculptra and Evolence plump or fill depressions in the skin. Even with a filler injection, as your frown muscles contract you still will have a noticeable frown line. Thus i always use botox first, because Botox corrects the basic problem... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

www.drseckel.com

Botox is the simplest, safest, and cheapest method

Judging from your pictures, I definitely would recommend that you begin with Botox as it is the simplest, safest, and cheapest method. If significant residual lines remain afterwards, then consider dermal filler. Seek a consultation with an experienced physican. I hope this helps!

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Botox

You can do both if you want, but these glabellar frown lines are ideally suited for Botox. You could add a filler if you want to, but I would save my money if I were you.

Scott E. Kasden, MD
Dallas Plastic Surgeon

You may need both

The best option is to get botox first and wait for 2 weeks. If you get enough improvement then you can avoid fillers. If you continue to have depression and vertical lines then fillers(Juvaderm or Restylane) will work better since your muscles are relaxed and will not fight against the fillers.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Both Botox and a Dermal Filler for vertical lines

Based on the picture, it looks like you need both Botox Cosmetic and a Dermal Fillers (Restylane, Juvederm, or Evolence). The Botox will decrease the stress on the overlying skin by paralyzing the underlying muscle. The Dermal Filler will fill the missing volume. You have moderately deep vertical lines, while appear that they would be there even at rest. The Botox only works on dynamic lines. That is why you need Botox and a filler.