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

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.

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

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. 

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

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.

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

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

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!

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.  

Assuming that your Botox treatment is working properly and adequately reducing muscle overactivity in the glabellar area, the appropriate type, volume, and placement of filler should eliminate these residual depressions.  I prefer 'layering' different types of fillers and varying the placement technique to directly address the type of furrow which means that the depth, magnitude and other characteristics of the depression must be specifically recognized and treated for best results.  Be sure to discuss this with your provider or seek the evaluation of a board certified plastic surgeon, dermatologist or ophthalmologist with experience and proven results in aesthetic medicine.