Deep static forehead lines? (photos)

These can be treated with a combination approach.  Please see a physician with experience .  Best, Dr. Emer.

Thank you for your question. You’re 28-years-old and you say you’ve had these forehead lines since you were about 13 to 14 years old. Though this is a genetic trait, you’re concerned about their appearance, especially since they are visible even when your forehead is relaxed. You’re concerned that Botox may not be adequate enough and you’d like to know if fillers can help in your situation.I can certainly help you with this, as I’ve been using Botox in my practice since 1993. I’m also a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years.Let us first differentiate between dynamic and static wrinkles. Dynamic wrinkles are wrinkles that appear when there is activation of muscle, which in your case is the frontalis muscle in the forehead. Static wrinkles are wrinkles that appear even when there is no active contraction of a muscle. In your situation, it appears that you’re dealing with both dynamic and static wrinkles.In our practice, we commonly address both static and dynamic wrinkles simultaneously. What we do is relax the muscle using Botox, then use a filler like Restylane to add volume to the lines in the forehead, and then use platelet-rich plasma to stimulate better collagen production in the dermis, which is the very foundation that keeps the skin smooth. Logically, if there is a deficiency in the foundation, then you would want to strengthen that foundation.Now, since you’re still quite young and your skin is still relatively thick, you don’t want your forehead to become completely paralyzed because it’s going to look very obvious that you’ve had Botox. I would limit the use of Botox so that the muscle still works, but there is less creasing of the skin. I’ve observed that the consistent use of Botox can significantly soften up lines in the face over time, and this is good for someone younger because then the lines will not continue to become deeper as they age. This is something to consider if you want to further improve your static lines.Keep in mind that it is unlikely that you will be able to erase the lines completely, as this is a family trait. Management is certainly beneficial, but you also have to consider cost, logistics and time that it would take to address these lines. You may want to simplify your treatment by doing something like Botox and platelet-rich plasma (PRP). What’s nice about these procedures is that they are low risk — if you don’t like the outcome, it is temporary and will go away. PRP, on the other hand, is derived from your own blood and that is a very low risk as well. I suggest that you also meet with qualified, experienced physicians who routinely perform these procedures. Learn about your options and consider the risks, benefits, and expenses. I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

Botox can be a great option for movement lines and static lines on the forehead.  Even deeper lines will begin to disappear after repeated injection.  It is especially important to be consistent and follow up before movement recurs to avoid back tracking.  With deeper lines, fillers can be helpful as well.  Hyaluronic acid fillers would be the best option for this area.  However, make sure to seek out an expert injector to achieve best results.