Do I need fillers or this can be fixed with Botox? (Photos)

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. I recommend Botox in your case, especially since you have strong muscles when you squeeze your eyebrows together. This movement is controlled by the glabellar muscles, which are responsible for creating the “11” lines or frown lines between the brows. If those muscles are overactive or naturally strong, they can create deep lines or contribute to an intense or tired appearance over time. Botox works by relaxing those muscles, softening the lines they create, and preventing them from becoming deeper with repeated movement. Filler, on the other hand, is typically used for static lines or volume loss, not for addressing muscle activity. Since your concern is related to strong muscle movement, Botox is the more effective and targeted treatment to help you achieve a smoother, more relaxed look. I hope this helps and best of luck!

To determine whether fillers or Botox would be the most appropriate treatment for addressing concerns on your forehead, it's essential to consider the nature of the issue:

Botox:

Botox is typically used to address dynamic wrinkles, which are lines that appear due to muscle movement, such as frown lines and forehead lines. If the lines on your forehead are primarily due to muscle activity, Botox can help relax the muscles and smooth out these lines.
Fillers:

Dermal fillers are used to address static wrinkles and volume loss. If the lines on your forehead are deeper and present even when your face is at rest, or if there is a need to restore volume, fillers might be more appropriate.
Next Steps:

Consultation with a Professional: Schedule a consultation with a board-certified dermatologist or plastic surgeon. They can assess your specific needs based on your skin type, the nature of the lines or wrinkles, and your aesthetic goals.
Personalized Treatment Plan: A professional will be able to recommend a personalized treatment plan, which may include Botox, fillers, or a combination of both, depending on the specific characteristics of your forehead lines.
Ultimately, an in-person assessment is crucial to determine the best course of action for achieving your desired results.

Hi Jessie!
You need a neuromodulator (like Botox or Dysport) into those muscles first (for the “dynamic rhytides”). Yours are very strong. Once the Botox kicks in, and residual wrinkles that persist at rest (static rhytides) can be further softened by strategic filler placement and resurfacing laser treatments. HOWEVER, this is considered a potential “danger area” for filler, as it can lead to blindness if injected incorrectly in this area. So, I would ONLY go to a doctor who is board certified in dermatology, or plastic/oculoplastic/ENT and who has experience and is comfortable injecting into this area.
Hope this helps!
Dr. Kiripolsky

So, the answer to your query is that for the most optimal results, both Botox and filler would be advisable.
That being said, at least from the photo, the most problematic issue appears to be the motion-related wrinkling for which Botox would be the treatment of choice.
If you are still bothered by the residual vertical line wrinkle between the eyebrows that remains when you are not emoting, then a low viscosity, malleable, cohesive HA filler an be used to elevate and smooth this static line.
You would be wise to consult with an experienced, board certified cosmetic dermatologist injector expert. Best of luck

Developing deepening lines in the glabella (that portion of the forehead) is extremely common. As you clearly demonstrate in your pictures, those lines are caused by muscular action in that region (corrugator muscles causing the vertical lines and the procerus muscle causing the horizontal lines). The easiest treatment to start with is a neurotoxin (e.g., Botox, Daxxify, etc). These medications will weaken or paralyze those muscles which will prevent you from being able to contract them and thus make you unable to create the lines. Over time, the muscles can lose some volume which can further soften the lines still present at rest.

Once softened with neurotoxin, if you are still troubled by the line(s) present at rest, your options include a resurfacing procedure (laser, peel, dermabrasion, microneedling) or select filler placement. If you opt for the filler route, make sure to seek an experienced injector as this area is one of the most dangerous areas of the face to inject given its robust blood supply around the eye. There have been cases of skin necrosis, blindness, and stroke with filler in any portion of the face, but this area is notorious for a higher rate of complication.

Hi there,
You could try some wrinkle relaxer injections which temporarily paralyse the muscle to stop you from frowning. When the muscle is relaxed it can help the appearance of that area looking smoother and soften the line between your brows. Hope this information helps. Thanks.

Botox is the gold standard to address dynamic muscle activity in the glabella area (sometimes called the 11's). The treatment is done in the office with final results seen after two weeks. The effects will fade gradually over three to four months. See an experienced injector for your treatment.

Botox will probably work. About 15 units to start. Will probably need about 3 sessions each 3 months apart for this to resolve. If it does not resolve by then, then consider a dermal filler, such as volbella.

I would definitely start with Botox and repeat the treatment every 3 to 4 months steadily for approximately a year. If the wrinkle does not disappear completely, you can have some fillers placed into it to make it considerably smoother. I hope this helps and good luck from Leonard Grossman, MD, organic plastic surgery New York City