I had both botox and juvederm injected in to my frown lines. The lines have diminished, but they are still visible (photo)

If my lines were very deep to begin with, is this reasonable or can they be reduced more? See photo.

Doctor Answers 9

Touch Up With Belotero

As Dr. Lichten suggests, you should wait  two weeks for the full effect of the Botox injections. If you are still unhappy with the results, you might return and ask for Belotero. This hyaluronic acid filler has the advantage in that your physician can go high up into the skin. Any prudent injector is aware that this is one of the "danger" zones, and deeper injections can imperil their patient. The  blood supply to the forehead can be compromised leading to necrosis, or due to the anastomosing vasculature of the area even blindness can result. Thus the importance of choosing your injector wisely.
Please be aware that this can be a difficult area to totally smooth out, so you might just have to live with an improvement and not perfection. 

Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

You can see improvement with time

Unfortunately, this is one of those times where patience is a virtue. Botox can take 3-7 days even up to 2 weeks, for the Botox to take full effect.  If your injections were recent, you can see improvement in the coming weeks. Juvederm, however, does take effect instantly. When I inject Juvederm, I always ask my patients if they are happy with the degree of correction while they are still in the treatment room.

Second, if this was your first treatment with Botox and Juvederm, we often see improvement with subsequent treatments in 4-6 months.  Patients report a "cummulative" effect where wrinkles soften more with each additional treatment.  

Third, although fillers and Botox are great treatments and very common, the surgical option of a brow lift should not be forgotten.  Many of my patients in Columbus, Ohio opt for brow lifting to get a longer lasting result or when they are not fully satisfied with injections.

Jason Brett Lichten, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 18 reviews

Botox and Juvederm in frown wrinkles

You need to give the Botox at least 2 weeks to fully work for you. The filler gets better each time you do it. Over time you will see continued improvement with this great combination. The wrinnkles didn't come over night and it takes time and sometimes several treatments over time to see improved correction. We also don't want to go too deep in the frown crease to avoid complictions. Be patient and over time you will see your continued improvement.

Esta Kronberg, MD
Houston Dermatologic Surgeon
4.9 out of 5 stars 30 reviews

I had both botox and juvederm injected in to my frown lines. The lines have diminished, but they are still visible

I suggest you give it a full 7-10 days so the effect of the Botox can kick in, after that you can schedule a follow-up consult with you provider to compare before and after photos 

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Reducing frown lines with botox and fillers

Botox takes 2 weeks to fully kick in so it depends on how long ago your procedure was and also how deep and prominent these lines were to start. If you have concerns return to your treating doctor to discuss. If you waited until these frown lines were extremely deep, then they may be hard to completely erase.

Omar Ibrahimi, MD, PhD
Stamford Dermatologic Surgeon
4.8 out of 5 stars 26 reviews

Botox and fillers to prominent "11's"

I do not know from your question when you had the injections done. Normally, I like to do the Botox first, wait 10 days for the full effects, and then put filler in. However, they can both be done at the same time too. It takes 10 days for the full effects of the Botox to kick it - but Botox only works on dynamic lines. The lines you get from moving your muscles. If you have significant lines at rest, these are static lines, which do require filler to fix. Give yourself the full 10 days to see how everything settles in. And then return to your injector if needed.

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Frown lines and Botox

The effects of Botox take two weeks.  If you have very deep glabella wrinkles then you may need a filler such as restylane or Belotero in that area.  Over time the wrinkles in the glabella area should smooth out and become less noticeable.  That is why it is importat to continue Botox in that area and not allow the area to become completely relaxed and wrinkled again.  Please consult a board certified dermatolgosit for the best results.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 78 reviews

Botox and frown lines

You need to do Botox for about 2 years and establish the correct dosage with your PHYSICIAN injector.  Eventually your lines will be less and less.  Some time they go away 99%.   I have had 5 patients who simply seemed to never frown after being on Botox for 3 or 4 years.  It is a long process.   Fine an ideal PHYSICIAN injector and stick with the injector.   My Best,  Dr C

George Commons, MD
Palo Alto Plastic Surgeon
4.5 out of 5 stars 36 reviews

Frown lines visible

I always educated my patients about the difference between static lines and dynamic lines.  If the wrinkle line is visible to you when you are not actively frowning then that level of wrinkle line will only respond to fillers.  Botox usually shows its maximum effect by 5-14 days.  Speak with your physician and consider fillers to help minimize those static lines.  Be aware that this area, the glabella, is a danger zone for fillers and should be approached with caution by the injector.

Jaime R. Garza, MD, DDS, FACS
San Antonio Plastic Surgeon
4.3 out of 5 stars 11 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.