I still have glabellar lines after two treatments of Botox, what else can I do to get rid of them? (Photo)

Question

Even after two treatments of Botox (20 units) I still have a frown line. Is there anything else I could do? Thanks.

Michael I. Echavez, MD · Answer

Injectable fillers can be used to fill in depressed areas of the glabella.  It is not uncommon to use Botox and a filler to obtain the best result.  There are a variety of fillers that could be used and it is a relatively more complex area to treat, so be sure to see an experienced injector.

Nima Shemirani, MD · Answer

Hi @tinacali! You may see more results from other neurmodulators like Xeomin, Dysport, or Daxify. Another suggestion would be additional units since your muscles in that area may be stronger. I would recommend an in person consultation to discuss a treatment plan for you.

Muhammad Mirza, MD (license suspended) · Answer

Thank you for your question and for providing the picture.  In order to obtain lasting results from your treatments, a combination of Botox and Juvederm.  This combination will provide you with the benefits of Botox along with Juvederm which is used to smooth the skin to and get rid of deep wrinkles and folds.  I recommend scheduling a consultation with an experienced physician for optimal results.  All the best!

Sonia Lamel, MD, FAAD · Answer

If you’re still experiencing movement, then you will certainly need an add an additional dose of neuromodulator if it’s been at least 2 weeks. If you don’t have movement, I find that some people who have more muscularity in their face can still see the outline of the muscles that make up the gown Ella in certain light. This should get better as you continue to use neuromodulators as your muscles will atrophy. Small amounts of a hyaluronic acid filler that is safe for more superficial injection can be used. Make sure you go to an experienced core injector as this area is more tricky to treat.

John Tang, MD · Answer

It appears from the photo that you would benefit from a dermal filler like Juvederm or Restylane as it would help to lift the depression in the frown.  Botox does not help with the indentation but rather it helps decrease the contraction of the muscle so when you actively frown the lines the lines are diminished.

Afshin Parhiscar, MD · Answer

Dear Tina In many cases, it has taken time for the elevens to develop and there is underlying volume loss. The neuromodulator helps with motion but won’t replenish the lost volume. Assuming your injections were done properly and with the right dosage, adding volume in the form of a filler in the lines can be a tremendous help in giving you a smoother and softer look. Look for an experienced and knowledgeable injector to help you achieve your desired look . Sincerely Afshin Parhiscar MD FACS

David Hansen, MD · Answer

you probably need a filler as well as the botox to help make the glabellar grooves disappear. Usually restylane or juvederm are used and makes a great improvement.

Camille Cash, MD · Answer

If you are still having movement of the treated area then further Botox may improve the result.  If you are no longer able to animate then the lines you see are static and more Botox won't help.  You can consider treatments such as Morpheus8 to improve overall skin tone and texture in this situation.

Anshul Gambhir, MD · Answer

Thank you for your message! It is possible that other neuromodulators, such as Dysport or Xeomin may work better for you. It may also be that you need more in that area for a better hold. Sometimes thin dermal fillers such as Volbella can be placed in between the brows to help soften resting lines. I would recommend a consultation with a provider in your area so they are able to assess the area in person!

Alix J. Charles, MD · Answer

Thanks for your question.  When I see a patient with glabellar lines, I always counsel them that Botox will help mostly with the component that is present with movement (the dynamic component).  If you see lines that are present even without facial expression, then it may take many repeated Botox treatments to smooth out these "static" lines.  An alternative for treating these static lines is a superficially injected HA filler like Belotero. Best of luck to you.

I still have glabellar lines after two treatments of Botox, what else can I do to get rid of them? (Photo)

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