I’m told over and over again “what’s wrong”. I won’t even be in a deep thought. The furrow between my eyes is the culprit. I know Botox is used to remove these furrows, but I hate the idea of going to a dermatologist every several months to get an injection. I can’t imagine fitting it into my hectic schedule. What alternatives are there for my angry-look problem?
How to Get Rid of "Angry Look" on my Face?
Doctor Answers 77
Are you angry or are your brows too low?
There are several reasons that we can be perceived as being angry. One is brow position, another is a deep crease between the eyes, another is a downturned smile to name just a few. As a facial plastic surgeon I have patients everyday who present this concern to me, That is where my background and experience can be used to present both surgical and non-surgical options. So this a complex question and is best treated by a doctor who has who has all the "tools" avaialable to give the patient the best result. Good luck.
Robert F. Gray, MD, FACS
The optimal treatment for frown lines is BOTOX as it deals with the root problem, the overuse of the muscles causing a frown (whether it be from frowning or just thinking). Fillers can also be used for deeper frown lines, often in addition to BOTOX. Topical creams with vitamin A acid/tretinoin, chemical peels, microdermabrasion, and laser all provide modest benefit to this area.
The angry look can come from multiple areas
Most patients with deep furrows will also have low brows and often thick brows on the medial (inside) portion of the brow.
There are multiple ways to improve this area. It depends on what is really creating the problem:
- Pluck the medial head of the brow so it does not appear so heavy and thick
- Decrease the bulk and action of the muscles at the area above the nose (the glabellar) with Botox
- Fill the grove(s) at the glabellar with a filler such as Juvederm
- Reduce or remove the muscles at the glabellar that create the furrow and fill the grove with salvaged tissue
- A forehead lift with muscle reduction or removal
- A brow lift with direct manipulation of the muscles.
Your next step should be to see a plastic surgeon who has the ability to help you choose between both the non and surgical options.
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A simple implant can permanently fix that angry look in less than 15 minutes
Botox or Dysport ($300) work well the soften that angry look for 3-4 months but still probably require a filler as well such as Juvederm or restylane ($550) or radiesse ($650). A simple little implant can be inserted under local anesthesia in about 15 minutes and can permanently fix the problem for about $1500.
How to get rid of "angry look" on my face?
Botox is by far the best option for treatment of your brow furrow and should last 3-4 months. There is a surgery to remove the muscles that cause that furrow but this usually leaves the patient with a very flat affect and is not recommended.
4 options to get rid of the "angry look"
The angry look is usually caused by overactive corrugator muscles (the frown muscles). This can be reduced or eliminated by four different means:
1) Botox. This is the simplest and least expensive method, but also typically lasts the shortest amount of time (3-4 months). Botox works by paralyzing the corrugator muscles so that you can no longer frown. With time the wrinkle just goes away.
2) Fat injections/fillers. Fat injections, Juvederm or Radiesse can all be used to fill in the crease(s) formed by the frown muscles. Fat has the added advantage that when it takes it will last for years.
3) Division/removal of the corrugators. This is a much more permanent solution since the muscles can be permanently removed either through a forehead incision or eyelid incision.
4) Brow-lift. This is similar to a corrugator division but has the added advantage of repositioning the brow into a more rested/ natural position.
Botox the best for angry look
Botox (or Dysport) would be correcting the only FDA approved indication in your case. Many of our patients (our being myself and the contributors to this site...I do not allow our aesthetician to inject) tell us that their friends think they are in a good mood or have returned from vacation.
I would recommend that you try Botox injections once, and then decide whether it is worth maintaining.
Most of us have also noted that after three or four times, you can space your Botox sessions further apart. Some of us also are seeing longer results with Dysport (lasting 4-5 months) so you might look into that alternative.
Botox best fix for angry look.
Unfortunately, surgery to correct the frown lines (either through a brow lift or through upper eyelid surgery) does not work consistently. Many people still need Botox afterwards, maybe less.
So for this particular problem, your best bet is a Botox injection 2 or 3 times a year. It only takes a few minutes, and there is no down time.
Botox to solve angry look
I believe that Botox injections are the easiest, safest and most consistent and predictable way to relax the muscles that crease or furrow the brow creating a tired or angry look. Often botox injections are needed even after surgical ablation of the nerves that supply these muscles as is done in a brow lift, so I would not pursue a brow lift unless your brow is truly sagging below the upper orbital bone causing heavy eyelids and droop. It is nice to consider surgical options but I am not sure when you consider all the pluses and minuses that surgery comes out ahead of simple and safe botox or dysport injections.
Botox is a quick procedure with relatively no down time
Botox or Dysport are really the most effective treatments for strong frown lines of the glabella (central forehead between the eyebrows). Although the results are transient, the treatment takes very little time. Your alternative is removal of the corrugator muscles of the glabella, which are responsible for your deep furrows. This can be done through an incision in the eyelids or as part of a brow lift. Although a very effective treatment, the downtime for surgery is usually 2-3 weeks - much harder to fit into a hectic schedule.
Hope this helps. Best of luck.
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.