Corrugator botox problems? Should I have dermal fillers instead?

Question

I have had botox for glabella frown lines. I have had repeated doses after 2 weeks and it makes little difference. I am told I am mail using my corrugator muscles and that botox here would cause eyelid drooping and I should have dermal fillers instead, is this the case (I'm only 33yrs)?

Kenneth Hughes, MD · Answer

Botox will help soften lines on the forehead, depending on how strong your muscle movement will determine how many units you would benefit from.  If your wrinkles are very deep to start, it may require a few rounds of Botox to smooth out the lines, up to 2 yrs of regular injections.I don't suggest having a filler injected because it could possibly cause a blockage to the blood vessels in that area. Seek a reputable injector who can give you an honest opinion and provide you with the result you wish to achieve.

Donald B. Yoo, MD, FACS · Answer

Are you still able to make a frown after the Botox treatment, or are you seeing lines even at rest?  With appropriate dosage and injection technique the muscle should be relaxed, even if not completely paralyzed.  This will work to soften your lines unless they are deeply imprinted in your skin and are present even at rest.  If this is the case, some filler may be necessary to complete the correction.

Steven F. Weiner, MD · Answer

For someone that has very strong corrugator muscles, Botox treatment will improve but completely resolve the movement.  Strength/"degree of frown" is graded from 0-3 with 3 being "severe".  In Botox clinical trials, a responder is considered to move at least 2 grades.  So, if you have gone from a 3 to a 1, you still are a responder but you will still have movement.  Also, there are about 15-20% that won't respond, according to their (Allergan's) studies (less than a 2 grade improvement).  Over time, the people who respond but don't go to 0, will have continued improvements with subsequent treatments at 3 month intervals in my experience.  If you are a non responder, I would try Dysport or Xeomin.  Hope this doesn't confuse you.  Steve Weiner, MD, Facial Plastic Surgeon, Destin, Florida.

Corrugator botox problems? Should I have dermal fillers instead?

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Corrugator botox problems? Should I have dermal fillers instead?

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