Vertical dent in forehead. Any suggestions? (photos)

Indentation on the forehead should be evaluated by a dermatologist prior to any cosmetic treatments.  Fillers work great in this area, for this specific reason, although Botox has a very limited role.  I would see a dermatologist with expertise in treatment of scars, facial asymmetries and alternative areas. See an expert. Best, Dr. Emer

Prior to any correction of the "vertical dent" that you are describing, you must be evaluated by a board certified dermatologist to actually determine the cause. Did this dent happen spontaneously or did it become apparent after a certain injectable procedure (e.g. steroid injection atrophy, post filler injection etc). Once the cause is established, in some instances meticulous placement of a filler injectable could be utilized to diminish such a dent and should only be administered by an expert cosmetic injector. 

Hi Chantal, I sincerely hope this is not an early mixed connective tissue disease. You need a full medical evaluation from a board certified dermatologist and rheumatologist  You will need blood work and perhaps even a biopsy because this could be a significant issue. I urge you to take this seriously.  And if medically everything checks out, then I would see a dermatologist that specializes in filler for this complicated area. This can absolutely NOT be done by anyone as you can get occlusion of the blood vessels and permanent scarring if it is done incorrectly.  Unfortunately, Botox was not the way to address this. Good luck, Dr. Downie

Thank you for your question.  Your photos are very good for demonstrating the problem from your hairline down to the glabella area.  Most all surgeons and physicians will and can use fillers  The choices are multiple all the way from Restylane, Juviderm, and Voluma.  In my practice, I use all the fillers.  One more option is Fat Transfer.  In my practice, I utilize fat in much the same way as filler with a long term result.  You have beautiful shaped brows and an elegance to your upper face.  This can be done with any of these as well as fat transfer.  I have put this in creases in the forehead many times.  The key with any injections is to do it smoothly with no visibility.  The injector must take into account the layers of the forehead from the skin down to the bone. 

Good Luck

Warmest Regards,

Dr. Walton Montegut

I have seen this in a scleroderma patient. I do think a derm consult is needed. If everything checks out ok. I would see a Plastic Surgeon for possibly placing an implant or dermal filler in this area.

There are a number of things that this can represent but most likely it is the way your frontalis muscle is divided. See a board dermatologist to be sure it is that and not something like localized scleroderma

Hi Chantal,

Please see your board certified dermatologist for help. There is a skin condition that can cause linear atrophy (a dent) of the central face. This can only be diagnosed in person after a proper physical exam. Best of luck!

so there are two possible things this might be. As it predates your botox, i suspect the botox has relaxed the muscles making that line more obvious. My first thought was a large vein. These are common in the middle of the forehead but usually produce a vertical hump, not a dent. The other is a forehead cleft. These are rare and it would be strange for no-one to have noticed it before now but they can creat profound bony dents in the skull. You should get examined by someone who has seen clefts before of even your family doctor to see what the dent feels like. Hope that helps Adam Goodwin