Can Belotero be used for glabella? Can Belotero be used for horizontal forehead lines? Also how long will the results last?

Question

I Have Read Horror Stories About Botox and Don't Want It.....Plus i Have Very Severe Nervous System Issues Already so I Know Botox Will Severely Damage My System, But I Have Bad Glabella Lines & Horizontal Forehead Lines at 38 Which Are Making Me Feel Very Insecure About My Appearance So I Am Looking For an Alternative Treatment......

Nelson Lee Novick, MD · Answer

The answer to your question is a resounding "Yes!"  Belotero Balance is in fact my filler of choice for the horizontal etched-in "worry line" (creases) along the forehead, the glabella (aka "eleven" lines, scowl lines, frown lines) between the eyebrows and the crow's feet lines to the sides of the eyes. Belotero possesses little to no tendency to give rise to the unwanted, bluish Tyndall Effect, when injected superficially (as needs to be in these cases).  Belotero is a filler, so it will only work on the lines left by years of moving the expression lines in those areas. Unlike neuromodulators (like Botox, Dysport, and Xeomin), it will not affect the ability to emote in those areas. The upside for you is that you will not be receiving any chemical that works on the nerves. The downside is that because you will retain the full ability to fully exercise your facial muscles, the injected filler will be broken down more quickly, very likely within eight to twelve months. Make sure that you seek consultation and treatment by an experienced, expert aesthetic physician injector and be sure to request to see his/her before and after photos of both the glabella and the forehead injected with filler. Best of luck.

Jason Emer, MD · Answer

Thank You for your question.Neuromodulators (such as Botox, Dysport, Xeomin, and Jeuveau) and soft tissue fillers like Belotero can improve the appearance of the forehead by reducing lines, wrinkles and folds. Deeper lines and wrinkles need a combination approach with Botox, fillers, lasers, and microneedling/PRP. I recommend getting a formal evaluation with a cosmetic dermatologist to develop a treatment plan that works for you. Best, Dr. Emer

Bruce E. Katz, MD · Answer

Thank you for your question. I would advise against using Belotero for the glabella and forehead lines. I recommend using either Botox or Dysport for those areas. Botox and Dysport are injectables that help with muscle control and smoothing fine lines and wrinkles. For optimal results, they should be done every 3-4 months.  For more information, I recommend getting a consult from a board-certified dermatologist.

Hratch Karamanoukian, MD, FACS · Answer

I do use Belotero in the right candidate for the glabella. Belotero is an excellent, thin product that is suitable for fine lines, wrinkles and filler for the lips. I love using this product in conjunction with others. Belotero is less suitable for deeper lines and volumization. 
H karamanoukian MD FACS

Kristin J. Tarbet, MD, FACS · Answer

I understand your concern. Filler in the glabellar area has its own risks as well. I would find a reputable injector for an evaluation.

Shaun Patel, MD · Answer

Yes, a softer gel hyaluronic acid filler such as Belotero, Volbella or Restylane Silk could be used to fill superficial lines such as frown lines and forehead lines. Unfortunately, I find that the filler does not last as long at these sites without simultaneous Botox injection to relaxed the muscle activity. I recommend you see an experienced injector for a detailed in person consultation.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Yes, fillers can be used in this area. The placement of filler is critical as there are lots of blood vessels in this area. The best is a combination of Botox and fillers, but if you have a contra-indication to Botox, than filler can certainly be useful. See a specialist as this area is high risk for fillers. Dr Davin Lim. Brisbane. Australia.

Joseph M. Pober, MD, FACS - Account Suspended · Answer

Hi Leslie. I appreciate your concern with regard to neuropathic conditions that require cautionary use of Botox.  
The simple answer is to try the Belotero first for both the horizontal forehead and vertical glabellar lines. Its usually safe, easy, and effective for about 3- 9 months, depending largely on how often you wrinkle your forehead. Belotero is usually my first choice for treatment of etched-in static wrinkles
For deeper creases or folds, fillers with higher G prime, such as juvyderm ultra plus and sometimes Radiesse may be judiciously employed.
Recently, for dynamic wrinkles, another non-surgical alternative to Botox that has been  introduced is the radiofrequency, high energy device called Thermi Rase. It is designed to “zap” the ( temporal ) nerve branches that move  your (frontalis,procerus, and corrugator) muscles. This serves to reduce forehead wrinkling for about a year according to some reports. 
Don's discredit Botox entirely - especially for dynamic unwanted expression lines, like the glabellar frown lines.  There are some neurologic conditions where  Botox may be considered in rare circumstances and with many warnings or caveats.  An example of  such a peripheral motor neuropathy is  myasthenia gravis(MG).  In such conditions, one must  localize the effect to purely the offending muscle very conservatively. One therefore starts a with minimal dose in high concentration to limit the spread of the Botox to only the offending muscle.  It should be mentioned, that with these precautions, the effect of Botox in MG has been reported to last as long as eighteen months, instead of 2-4 months. 
  
I hope this gives some perspective to your choices.
At the end of the day, it is always wise to consult a Board Certified Plastic Surgeon or other Core Specialist when there are any medical concerns.A forehead lift to smooth out redundant skin along with static and dynamic wrinkles is the gold standard. Everyone deserves the most experienced and knowledgeable approach to best meet their aesthetic goals.  All the best.

Robert T. Buchanan, MD (retired) · Answer

There are a number of things you need to know. First is that the lines are due to muscle function and eliminating this function is necessary to eliminate them. Botox is the easiest method of doing this. Even with "Very Severe Nervous System Issues," Botox is unlikely to worsen these problems. Most of the "horror stories" you have heard are because there are a lot of very unskilled practitioners using Botox. The only other way to reduce the muscle function is with a brow lift. Therefore see a plastic surgeon who is an expert in brow lifting and use of Botox and fillers. Once you have eliminated further muscle contribution, you can look at the second step. This consists of using a filler to elevate any lines still present. Belotero used to be my first choice, though I have recently changed to Juvederm Volbella. You  may get away with injecting them only once if you also begin using Retin-A and Obagi ELASTIderm regularly since they stimulate collagen and elastic tissue, using some of the hyaluronic acid from the filler to fill in the lines permanently.

Can Belotero be used for glabella? Can Belotero be used for horizontal forehead lines? Also how long will the results last?

Answers (9)

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