Combination of Juvederm, Restyalon, Botox Recommended for Glabella?

A PS recommends a combination of juvederm and restyalon with Botox in the glabella area and the verical lines between the brows? Would you recommend this conbination and how long do you think this will last.

Doctor Answers 10

Combination of Botox and fillers

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Combinations work well with Botox and fillers. The filler should not be a thick filler and Juvederm Ultra and Restylane are fine for this area. Botox is often done first and then a filler weeks later if there is still a crease present. Too much filler in this area risks an ulceration that can lead to a permanent scar. I’m not sure why both Juvederm and Restylane would be used in the same area though.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Combination of Botox and Restylane for Glabella

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It should last up to six months.

Works very well. Ideally you should get Botox first and wait for one week to see how much improvement you get. Then you have a better idea of how much Restylane you will need to correct the lines.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Restylane and Botox for frown lines

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My approach is generally to treat the glabellar region with Botox first, then have the patient return to see me in 2-4 weeks when Botox has taken its full effect. If filler is needed, it can be injected at that time. I prefer Restylane in this area (in very small volumes). Botox would wear off in approximately 3 months, whereas filler typically lasts considerably longer.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist

Combining fillers with Botox

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Botox is a great treatment for glabella line which are often due to muscle overactivity. This may be all that is necessary. Sometimes there are dermal deficiency creases which remain after the Botox has taken effect. In this case, a filler may be of benefit.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Botox and Hyaluronic Acid (Juvederm or Restylane) for Glabellar Lines; 1 +1= 4

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Hi Norm,

One of the mysteries of facial injectables is why the combination of simultaneous hyaluronic acid filler (Restylane or Juvederm) and Botox in the glabella is so effective at not only correcting vertical glabellar folds (the "11" lines), but also why the combo is so effective at nearly eliminating the folds at rest even when the Botox had worn off.

The two treatments complement each other. The sum is greater than the parts (1+1= 4). It is thought that hyaluronic acids stimulate collagen production. With the muscles in the area not moving for months, the effect is magnified.

Some physicians prefer to wait until Botox has taken effect before filling with h.a. Others will do it at the same visit. I have not found a significant difference between treatment schedules.

Enjoy your treatment.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Combination of Restylane and Juvederm

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This is a good plan but I am confused as to why there would be a combination of Juvederm and Restylane. It would seem one of the other could be used in that area, but I cannot see the rationale for both. Perhaps, your plastic surgeon was thinking of using one of the fillers elsewhere.

Botox of course is the standard treatment for the glabellar area, and still the only treatment area approved by the FDA for cosmetic purposes. Oftentimes, Botox is injected and fillers utlized two weeks later, after the affect of the Botox has been ascertained.

Your physician must be careful as this area is prone to the dreaded necrosis phenomenon occasionally seen with fillers. I certainly would trust a plastic surgeon or dermatologist to inject this area, but would be wary of other physicians, never mind non-physicians, trying this. Heard of two many scary stories.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Botox followed by one filler

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I would be wise to begin with Botox to see how much of the dynamic lines could be removed. Muscle relaxation might do it. Following this or might choose to have a filler (either Juvederm or Restylane) to help with the static lines.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Glabellar frown lines and wrinkles: use Botox first followed by fillers

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I generally proceed as mentioned. I tend to prefer Botox first and have patient's return 1 month later to assess the need for fillers. Botox needs to be repeated every 3-5 months whereas the fillers tend to be repeated every 9-12 months.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Fillers and Botox

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In general I prefer to do Botox first to see what effect this will have on the glabellar lines. If they flatten enough that you are happy, fine. If they are improved, then you may need less filler in this region (although this is a region prone to problems and you should discuss this with your plastic surgeon). There are other surgical alternatives to permanently address this area; but again discuss this with your plastic surgeon.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon

Heck no (but)

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I don't have benefit of exam, but I don't understand that treatment plan. Botox is usually sufficient, while once in a while, supplement with filers are helpful.

You will be getting into expensive no-operative treatmentst that yield temporary results. You may want to consider a brow lift.

Hope this helps.


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