Deep Glabella lines at 30. Botox and fillers and still noticeable. What can I do? (Photo)

Question

I'm 30 and have deep glabella lines. I've been getting Botox every 3 months for a year. As well as fillers even went back twice for a touch up. The lines have improved but are still noticeable. What should I do?

Gabriel Chiu, DO · Answer

Thank you for your inquiry.  I have a few questions for you.  How many units of Botox are you getting with each treatment and can you move after each treatment? It's possible that you may need more units of Botox or to try Dysport at your next visit.  Additionally, do you sleep on your face? Sleeping on your face can cause facial wrinkles.  One thing to consider trying in addition to the Botox/Dysport and filler is laser resurfacing to the wrinkles.  You will need 2-4 laser treatments.

N. Bill Aydin, MD · Answer

Hi, Thank you for your post. It is hard to tell from the photo that you posted but it looks like some more filler can be added to improve your results. I would recommend making sure that you are going to an expert injector for all of your botox and fillers. Micro needling might also help to improve your lines.

Philip Solomon, MD, FRCS · Answer

Deep lines can be challenging to treat.  You may want to discuss with your provider your dosing to ensure that you are being adequately treated.  They may be able to increase your dose or may add some more filler.  Treatments such as PRP can also be helpful in stimulating collagen production.   You may also want to discuss whether or not you are a candidate for resurfacing.  Best of luck,Dr. Philip Solomon, Solomon Facial Plastic

Ramandeep Sidhu, MD · Answer

Just looking at that pic I think there is more room to add a filler and completely get rid of the lines and then from there onwards continue with regular botox to prevent those from coming back.

Daniel Barrett, MD · Answer

Dear GoGirl86,Botox and dermal fillers are great options for glabella lines. Botox is generally an on off switch for muscle activity. I get a fair amount of actors/actresses in my practice that are looking to reduce wrinkles but keep some expression. Finding an experienced physician injector is your best bet.Daniel Barrett, MD, MHA, MS Certified, American Board of Plastic Surgery  Member, Am. Society of Plastic Surgery

Harold J. Kaplan, MD · Answer

Hi GG.  It still appears that you have a depression at the area around each glabella line.  If you cannot contract the muscle in this area (frown), then you need more filler as the depression makes the lines more visible.  Alternatively (or perhaps in addition to the filler), we may sggest laser resurfacing.  Laser resurfacing would not be effective for the depression, but if the 11 lines are etched into the skin (a very fine crease) even after the Botox and filler, then resurfacing can help smooth out the skin where the very fine crease shows.  Hope this helps and good luck.  See below link for similar cases.

Jason Emer, MD · Answer

In addition to Botox and fillers, lasers and microneedling/prp can help give improvement to deep glabella lines. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Christopher Manios, MD · Answer

Thanks for your question. 
I seems that you are doing all the right things. Once lines do occur they can be difficult to completely resolve. I think that you should continue to do Botox to make sure that this lines don't become worse. Another option may be to inquire with a specialist about laser resurfacing. If you choose to try laser resurfacing, you should continue to do Botox. If you notice movement in this area, you may require a higher dose of Botox or you may want to try Dysport

Warren B. Seiler III, MD · Answer

First of all, I would make sure you are seeing an expert in Botox and filler and discuss your concerns with him/her.

I would continue what you are doing, as Botox will soften the glabella lines the more you receive it. Another treatment you can consider in-conjunction with the Botox and Fillers, is laser treatments. A skin resurfacing laser can help with fine lines and wrinkles! A laser, such as, Fraxel or Co2 can penetrate deep into the skin to ultimately help diminish and prevent wrinkles. I hope this helps!

Andrei Metelitsa, MD, FRCPC, FAAD · Answer

You could benefit from additional filler injections in this area. This is considered to be an advanced technique as there are numerous vessels in the glabellar region so injections should ideally be performed by a board certified dermatologist or plastic surgeon. If done properly, a soft hyaluronic acid filler such as restylane or juvederm could further soften your lines.

Deep Glabella lines at 30. Botox and fillers and still noticeable. What can I do? (Photo)

Answers (20)

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