Will botox help with the indentation above my eyebrows due to years of frowning? (Photo)

Question

I am 47 year old. And I have 11 between brows but I am more concerned with the muscle indent above my eyebrows.

Nelson Lee Novick, MD · Answer

At least from the photo provided, there appears to be hypertrophy of the muscles in the glabellar region, whose bulging can account for the depressions you dislike below them. Botox typically works well for this problem by softening the static muscular contractions that are contributing to this. You would be wise to consult with an experienced, board certified cosmetic dermatologist injection expert and best of luck.

Zoran Potparic, MD · Answer

This dent is most likely due to hypertrophic corrugator muscle? Treatment with Botox may diminish hyperactivity and partially correct deformity if used properly and continually. Long term solution is endoscopic muscle removal, possibly with some fat grafting. Good luck.

Anna Chacon, MD, FAAD · Answer

At 47, what you’re describing is something I see very frequently in patients who have spent many years unconsciously frowning or squinting. The vertical “11” lines between the brows are caused by repeated contraction of the corrugator and procerus muscles, but the indentation or hollowing above the eyebrows is often a different issue.

Looking at your photo, I do see glabellar (11) lines, but I also see a shallow groove and contour change just above the brows, particularly in the area where the frontalis and corrugator muscles interact. This can happen from a combination of:

Long-term muscle overactivity
Loss of subcutaneous fat with aging
Changes in the underlying bone and soft tissue support
Skin thinning over time
Will Botox Help?

Yes — but probably only partially.

Botox can:

Relax the corrugator muscles that create the frowning motion
Prevent the indentation from becoming deeper with continued muscle contraction
Soften the dynamic component of the crease when you make expressions

What Botox cannot do well is fill a hollow that is visible even when your face is completely relaxed.

A Useful Way to Tell

Ask yourself:

Does the indentation become much deeper when I frown? → Botox is likely to help significantly.
Is it still visible when my face is fully relaxed and expressionless? → There is probably a static volume-loss component that Botox alone will not correct.

From your photo, I suspect there is at least some static indentation present, meaning the area may not completely smooth out with neuromodulator treatment alone.

What Often Works Best

For patients with your concern, I often think of treatment in two layers:

1. Relax the Muscle

Small, carefully placed Botox injections to the glabella (11 area) and sometimes the lower frontalis can reduce the downward pulling that contributes to the furrowed appearance.

2. Restore Support if Needed

If a true hollow remains after the muscles are relaxed, options that may be considered include:

Hyaluronic acid filler placed very conservatively in the superior brow/glabellar transition
Biostimulatory treatments (such as diluted calcium hydroxylapatite in selected patients)
Occasionally fat grafting for more significant upper-brow hollowing
One Important Caution

The area directly above the eyebrows and between the brows is one of the most technically demanding areas for filler injection because of the blood vessel anatomy. If volume correction is considered, it should be done very conservatively and by an experienced injector.

My Honest Impression

I do think Botox is worth considering for the frowning muscles, and it would likely improve the 11 lines and reduce the tension that is accentuating the indentation. However, based on the appearance in your photo, I would not expect Botox alone to completely eliminate the groove above the brows if that contour change is present at rest.

The encouraging part is that your indentation appears relatively shallow rather than severe, so even a modest reduction in muscle activity can often make the area look softer, less shadowed, and less tired, which is usually the improvement patients notice first.

Will botox help with the indentation above my eyebrows due to years of frowning? (Photo)

Answers (3)

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