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Hi Carly, I would use combination of Botox to de-activate the muscles in that area and filler to improve the contour. I have used this successfully in a number of patients. You should have a geat improvement with this combiniation. Hope this was helpful.
If the scar is made worse by muscle contraction, Botulinum Toxin (Dysport and Botox) may help ease or soften the appearance of the scar, but are not likely to erase it completely. This may require a combination of scar revision and/or fillers.
Botox and Dysport do not directly treat scars. They are used to treat the dynamic wrinkles and furrows that result from the movement of the muscles of facial expression. These substances are called neuromodulators, i.e. chemicals that interfere with nerve impulse transmission to muscles. As such, they do not directly impact on the fibrotic collagen or its formation within scar tissue. However, recent evidence suggests that if these chemicals are injected in around a scar, especially a developing scar, they may reduce muscle activity around the scar sufficiently to allow a the scar to heal in a more esthetic fashion. For this reason, I routinely inject scars located in and around the facial expression muscles with Botox or Dysport as an initial phase of their treatment. Then depending upon the type of scar and precise location, I follow with either the use of fillers, dermaspacing, medical microneedling, mesotherapy, or scarabrasion. In this case of an indented linear scar across the top of the bridge of the nose, I would likely supplement the Botox injections with one or two dermaspacing treatments spaced at six week intervals to free up the bound down fibrotic scar tissue and then follow with the placement of a superficial filler, such as Restylane L or Juvederm Ultra XC.
when the scar is mature, Botox is not expected to improve the appearance. If the scar is new, then Botox may relax the surrounding musculature and decrease the pulling of the skin as a sutured wound is healing and may help improve the ultimate appearance of the scar.
There have been a few recent publications in the medical literature about the use of Botox to reduce facial scars. These were newly acquired facial scars from trauma or procedures like lesion removals. Botox relaxes the surrounding muscles so there is less pull on the freshly healing scars. These scars were thinner and less visible than similar scars without Botox treatment. Unfortunately, i don't think this will be as effective for old scars unless the action of the surrounding muscles is exaggerating the scar.
Restylane or juvederm would do well to fill in the depressed scar on the nose bridge. Botox would only help to prevent it from getting worse. Sincerely, David Hansen,MD
The Botox would only help prevent the scar from getting progressively worse from the repeated muscle movement (such as wrinkling your nose) which would make the scar wore with time. But to get improvement or correction of the scar you would also have to use a filler (ie: Restylane or Juvederm) to help fill in or plump up the depression. You have to be careful not to overcorrect or it could make your nose look too "fat". As you age, this scar will also look worse from normal sagging (called ptosis) of the forehead and brow which will further accentuate this scar. Restylane and Juvederm are temporary fillers which will have to be done every several months. Botox is also temporary and will have to be done every 4-6 months. There are permanent fillers such as Artefill that you may want to look into. Artefill is the only permanent filler that is FDA approved in the U.S. Silicone is also permanent but there is a lot of controversy over its safety (I personally would not do silicone).
the deep lines between our brows are what we term dynamic lines and do respond to botox or dysport. If they are present without animation, then a dermal filler may also be required to significantly change their appearance.
If this is s dermal depression form animation , then perhaps Botox can soften it a bit. If this is an actual scar from an accident, I doubt that Botox will help at all.
For small indented scars between the eyebrows I would most likely use a combination of Botox to immobilize the area so muscle contraction does not further deepen the scar and a small amount of Restylane or Juvederm to help fill it in. Often times this combo can be quite successful to minimize the appearance of atrophic (indented) scars. Alternatively some lasers may be used to help stimulate collagen to fill in the scar more permanently. It depends on the size and type of scar as to which method would be preferable. Good luck.
You may require more but it is more likely that you are compensating wtih other muscles that were outside the treatment area.
Time will heal it. Botox reverses when the nerve endings that have been bound by the botox regenerate. This takes approximately 3-4 months. No massage or therapy will make that happen faster.
There have been occasional reports of "bad batch" of Botox in which the Botox injected did not have the desired effect. I would wait about 1-2 weeks and see if there is still not effect and then bring up your concerns with your treating physician. A reasonable thing to do at...
