Deep static forehead lines? (photos)

I'm 28 & have deep lines/wrinkles on my forehead. Its been this way Some 13-14, I'm think it's genetic because most of my family have the same. But I'm noticing they seem deeper & even when my forehead is relaxed. I was thinking of Botox for this but since the lines are there when the muscles are relaxed I don't think alone Botox will work. I was wondering if it is possible to use dermal fillers to fill in the lines?& then Botox to relax the muscles too. Also what filler would be best for this?

Doctor Answers 22


You will be surprised how well Botox alone will work.  Be patient though it will take a few times to see complete resolution of the lines. Don't do filler on those lines.  It will not work well. 

Good luck!

Saint Louis Plastic Surgeon
4.9 out of 5 stars 30 reviews

Deep forehead creases at rest

I agree with your insight that the deep creases on your forehead may be a family trait, and can appear at a younger age. You will need Botox injected conservatively, keeping in mind that your eyebrows will be in a more relaxed position and your brow could appear a little "heavier". Botox alone may be enough to eliminate the creases at rest if they're early and superficial (unfortunately there's no photo of your relaxed forehead to make a better assessment). If you have deep creases at rest, hyaluronic acid fillers will help to correct the depressed creases left after Botox takes effect . Etched-in creases are best corrected with Belotero Balance by itself or layered over a deeper filler such as Juvederm. This may take a couple of appointments. If you do develop the appearance of the heavier brow after Botox, it will reverse itself as the muscles recover from Botox. Sometimes surgical weakening of the forehead muscle is appropriate, but only if Botox and fillers don't give you the right balance and if you are inclined to pursue surgical treatment options. Hope this helps.

Renuka Diwan, MD
Cleveland Dermatologic Surgeon
4.8 out of 5 stars 20 reviews

Deep static forehead lines? = consider Botox and fillers #botox #fillers #drmesa #belotero #juvederm #menlines

In my practice, male patients with deep static forehead lines could be improved with a combination of Botox and soft tissue fillers. Very deep lines benefit the best from combination superficial soft tissue filler (Belotero) with deep filler (Juvederm or Restylane) in combination of botox.

Patients interested in treatment of static forehead lines should make a consultation with a Board Certified Plastic Surgeon specialized in natural  Botox and Fillers results. 

John Mesa, MD
New York Plastic Surgeon
4.9 out of 5 stars 125 reviews

Deep Forehead Lines

Dear jerronba:

Thanks for sharing your photos!

You're a good looking guy with deep forehead wrinkles. Once the skin has lost its "rubber band" - like elasticity it will crease in an accordion-like fashion. The dermis will thin and eventually etch a near-permanent line or wrinkle. 

As you are aware, Botox is a muscle relaxer and properly injected will soften the mid-forehead lines. If Botox is injected for the lateral lines, the wrinkles will soften  but your brows and your eyelids will droop as you appear to be maximally using your frontalis muscle to lift your brow and eyelids.  

Please consider:
  1. Botox to soften the forehead lines, followed by
  2. Filler injection. I have found Restylane Silk in the forehead to provide a great smoothening improvement.
  3. Should you wish to "erase" the lines, retinoids will be necessary to hasten the collagen wrinkle-erasing process.
Please consult with a Board Certified and well experienced Plastic Surgeon to review your options. I wish you all the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 81 reviews

Botox works great for the forehead

Botox works surprisingly well in the forehead. Even deep lines can smooth with a single treatment. Realize though that Botox will prevent you from lifting your eyebrows as well as you would normally. I always recommend seeing an injector with extensive experience. Botox should always be customized to an individuals specific muscular anatomy.

Andrew Campbell, M.D.
Facial Plastic Specialist
Quintessa Aesthetic Centers

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Forehead wrinkles

Both of your photos show a lot of eyebrow elevation which ends up causing the forehead wrinkles with repetitive muscle contraction. Botox should help to weaken the strength of the forehead muscle contraction but it will also decrease the amount of elevation of the eyebrows and put them in a more natural position. Repeated cycles of Botox should also soften the depth of the wrinkles since the muscles won't be contracting as strongly.

Robert J. Smyth, MD
Cincinnati Facial Plastic Surgeon
3.5 out of 5 stars 11 reviews

Botox or fillers for your forehead lines?

Your question is a good one and it is one that I am asked virtually every day in my clinical practice. While you are somewhat young to have such crisply defined "character" lines, you can expect considerable improvement with Botox. After Botox is injected, it takes a few days to notice that it is relaxing the forehead muscles. Then by about 4 weeks, the lines should smooth out, and hopefully disappear completely.  The effect of Botox lasts about 4-5 months. If you obtain the desired result, then plan on maintaining the smooth look with regular injections about twice a year.The forehead skin is thin but dense and therefore injectable fillers are not ideally suited for this location: they will produce elevated ridges. Laser resurfacing is probably overkill for your otherwise healthy skin. The most long lasting result is produced by a brow lift surgery during which the frontal muscle which produce wrinkling are eradicated permanently. This might create a frozen look which is irreversable. For now, Botox is your best option.

Tad Grenga, MD, FACS
Suffolk Plastic Surgeon
5.0 out of 5 stars 15 reviews

Deep static forehead lines?

Thank you for your question.  I recommend Botox alone.  You are young enough that the lines should resolve on their own likely in 3-12 months if the Botox injections are maintained.  If after that amount of time they are still visible, you can consider laser resurfacing in addition to the Botox.  Consult with a board certified plastic surgeon or dermatologist to discuss your options.  Best wishes!

Nicholas Tarola, MD
Nashville Plastic Surgeon
4.9 out of 5 stars 57 reviews

Deep Forehead Lines

Whenever there are deep static or dynamic forehead lines one has to look for the reasons before fixing the lines. The most common reason for development of these lines is a condition called eyelid ptosis(droopy eyelids) which is the inability to open the eyes fully without the help from the forehead muscles. Those patients who have eyelid ptosis force the eyelids open using the forehead muscles. If the ptosis is corrected in early stage the lines may go away completely or mostly. In a late stage a combination of ptosis correction and forehead lift would resolve the problem.
Ptosis could be the result of muscle weakness, detachment of structures, congenital, significant amount of excess skin or neurological problems. It is hard to judge from the pictures that you have posted as to what is causing these at your age. Although your seem to be forcing you eyebrows up with your forehead muscles. You may consider visiting a plastic surgeon who has experience in both forehead and eyelid surgery to see what would help you to get to the root of the problem. Botox effect is going to be temporary and you have long life ahead of you.
Good Luck

Bahman Guyuron, MD
Cleveland Plastic Surgeon
4.7 out of 5 stars 22 reviews

Treatment for deep static and dynamic forehead lines? Williamsville NY Botox

Thank you for posting your question and photos,

I recommend an algorithm with Botox injections combined with laser resurfacing.

Dr. Karamanoukian

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.