Does Restylane Work Like Botox on Forehead Lines and Wrinkles?

In the vast majority of patients with glabellar frown lines,
the treatment of choice is Botox.This
product works by decreasing the ability of the forehead muscles to
contract.When strategically placed it
can impact the glabellar muscles and minimize vertical glabellar frown lines.Unfortunately,
Botox may not totally alleviate these frown lines when they are of long
standing duration and deeply etched into the forehead.Under these circumstances, injectable fillers
may be effective for treating these problems.These fillers actually fill in the crease and make them disappear.In most
cases we utilize hyaluronic acid fillers.These include Juvederm, Restylane and Perlane to name a few.These products typically last about 6 to 9
months.In patients who want more
permanent solutions we utilize Radiesse.All of these products are associated with excellent clinical results and
high levels of patient satisfaction.If
Botox doesn’t adequately address vertical glabellar frown lines, injectable
fillers offer an excellent alternative.If you’re concerned about vertical frown lines consultation with a
specialist is appropriate.This
specialist should be able to determine which option is best for you.

The horizontal lines of the forehead and the vertical lines between the eyebrows are dynamic in origin, meaning they are caused by hyperactive muscles of expression. Because Botox and Dysport work to relax the muscles, they treat the cause of the wrinkles in a way that dermal fillers such as Restylane can't.
However, in some cases the wrinkles are etched in from years of squinting or frowning, so fillers might be used in addition to Botox in those situations, but not typically as a first line choice.

Although it is not commonly used in the forehead and between the eyes, Restylane is an option in these areas. Restylane is not FDA approved for the forehead, but can be effective to fill larger wrinkles and folds that have not or will not revolve completely with Botox.
Botox is the standard for the upper face because muscle activity causes most of the lines around the eyes and forehead. With that said, we do use it sparingly in between the eyes for very deep vertical lines.

The lines that form on the forehead are a result of muscle activity over time. Minimization of activity of these muscles helps give the forehead a more relaxed, smoother appearance. Botox is a form of chemical neurotoxin that minimizes communication between the motor nerve and the muscle. The reason Allergan has been so successful is that Botox really works!
Restylane is a hyaluronic acid based filler that is injected to lift up facial lines. In my opinion it is more appropriate for lower facial and lip lines, volume enhancement of the lips, and nasolabial folds.

In order to choose the best therapeutic option(s) for wrinkles, it is helpful to understand the underlying reason(s) behind these lines of maturity. Forehead, crows feet lines are mostly due to excessive and involuntary contraction of facial muscles and thus is better treated with botulinum toxin such as Botox or Dysport. Whereas smile lines around the lips along nasolabial folds and the corners of the mouth are mostly due to loss of facial volume and immediate gratification can be provided by fillers such as Restylane, Juvederm, Evolence or Radiesse. On the other hand, most of the sagging of our cheeks, jowls is due to loss of bony support that we used to have in our youth along brows, upper cheeks and the mandibles. If you are not quite ready for face lifts, Sculptra can be a wonderful option to restore a more rejuvenated facial contours and the cosmetic benefit may last couple years.

Botox is the treatment of choice for the horizontal lines of the forehead and the vertical lines between the eyes, just above the nose. However, in certain cases, if the Botox doesn't sufficiently improve the vertical lines between the eyes, it may be necessary to inject a filler in that area if the wrinkle (rhytid) is especially deep.
Botox weakens muscles temporarily which softens the appearance of lines.
Restylane, Juvederm and other fillers merely "fill in" the deeper lines caused my chronic muscle contraction; which can't be treated by Botox alone.
Consult with a board certified plastic surgeon prior to any treatment.

Restylane and Botox are two different formulations meant to address different issues. Restylane is a hyaluronic acid-based dermal filler meant to smooth wrinkles, sculpt the lips, and shape facial contours. It works by adding volume underneath the skin. Botox is a neuromodulator meant to stop nerve signals from reaching muscles, stopping them from contracting and causing wrinkles. A consultation can help to best determine which type of treatment can address your specific wrinkles.

Hi Mal - Great question.  Dermal-fillers like Restylane, Perlane, Juvederm and Radiesse work differently than Botox or Dysport.  Dermal-fillers treat the wrinkle by restoring lost volume to the area.  Botox and Dysport are treatments that suspend muscle movement; essentially freezing the muscle from making the frown or crease.

I often treat patients with both products for optimal facial rejuvenation without surgery.  I would not choose one over the other, as the treatment compliment each other and are not interchangeable,.

Best wishes on your treatment.

David C. Mabrie, M.D., FACS

 

 

Restylane is a very popular and effective hyaluronic acid-base dermal filler. It has been used widely throughout the face for the correction of deep lines and wrinkles. Restylane works very differently from Botox. Botox is a medicine that can help the muscles relax and prevent wrinkles that are caused by contracting muscles. Restylane is a dermal filler and can fill the area underneath the wrinkle to plump up. In the forehead, we typically recommend that the patients began with Botox to help relax the forehead muscles and smooth their brow. In some patients who continue to have prominent forehead lines after Botox, a dermal filler such as Restylane or Juvederm may help.
 

When we talk about bothersome lines in the face, they can be broadly divided into anatomic areas of tissue loss with time, such as marionette lines, the nasolabial folds, or the tear trough under the eyes, or functional lines from hyperactive muscles, such as the glabellar frown lines, forehead lines, Crow's feet, etc. I like to conceptualize the anatomic "depressions" as the valleys, and the hyperactive lines as the mountains, both of which cause wrinkles. Fillers such as Restylane are best used to "fill-in" the anatomic valleys, and Botox is used to relax the muscular "mountains". The best approach is to use each product in different areas of the face depending on the individual problem...