23 year old - horizontal lines between eyes? (Photo)

Studies have confirmed my own personal experience that the results of combining Botox (or Dysport or Xeomin) with a filler for fine lines between the eyes (and elsewhere, such as the forehead, as a matter of fact) prolongs the desired aesthetic result considerably beyond the expected duration for each used alone. The combined effect is known as synergy. Botox addresses the dynamic (i.e. the motion related) underpinning of wrinkle development. Fillers address the static component (i.e. the etched-in, crease lines that form after daily repetitive use of the muscles of facial expression beneath the skin). Botox used alone tends to last 3-4 months. Fillers used alone about 6-8 months. Combined use of Botox and a filler tends to last at least a year. So, this combination approach, which can easily be performed in one ten minute treatment session, may fit better into your budget and schedule. Implants are inappropriate,  a medium depth chemical peel would be overkill and poses needless risks for scarring and dyspigmentation, and a series of superficial peels is best reserved for the most superficial of lines and would do little for the motion-related component. Fraxels have been disappointing in my experience and not worth the time and money and appear backed far more by industry supported marketing hype than hard science. You would do well to seek consultation with a board certified aesthetic physician. Best of luck to you.

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thanks for your question and your photo. Since you’d like to avoid repeat injections, laser skin resurfacing can help minimize these lines. However, you would require a series of treatments and results can take months to develop. I’d recommend a combination of BOTOX® and dermal fillers. BOTOX® typically lasts around 4 months, but many fillers can last up to a year, so touch-up treatments don’t need to be a hassle. Good luck!

These lines look like "bunny lines" developing from scrunching your nose.  Low dose Botox will relax these.  This type of facial movement responds well to biofeedback, in that, if you can't do it, you tend to stop doing the 'scrunching'.  Due to blood flow in this area, I agree that this is a danger zone for injecting fillers requiring long time expertise, and would only consider if the Botox does not adequately address your problem.  I have been injecting Botox since the 1980's and fillers since the 1990's, and there are certain areas where, for safety reasons, I will not inject fillers.  

It looks like you might be a good candidate for a little bit of Botox in that area. This can soften these fine lines to minimize the risk of them getting really deep with continued use.

I would consider botox first and if that didn't soften the lines completely consider fillers next. As far as fillers are concerned, this is concerned an advanced area for injections due to the underlying anatomy of the area. 

Good morning and thank you for your question! Botox/fillers would be your best option for immediate results. Lasers, in addition to proper skin care, can also help reduce the appearance of fine lines and wrinkles. It will, however, take a series of laser treatments to see a noticeable improvement. I would recommend fraxel laser or fractora (microneedling with RF) to help with your horizontal lines. Best of luck! For more information please feel free to visit our website!

Thank you for your question. The best treatment of wrinkles due to facial expression is Botox injections. Botox will also prevent the wrinkles from getting worse with time. Peels, lasers... will help but resuls are not permanent.. I hope this help. All the best, Dr. Michon