Follow-Up Question: What Can I Do About This Terrible Forehead? (photos)

Reposting this with b4 and after pics. I received Botox for the 2nd time within 2 years. I went to a different dr. this time than the first time which was a combo of Botox & Juvederm because I didn't notice a difference. I'm supposed to go back in a couple weeks to discuss my "progress". Obviously I'm not satisfied cuz the picture shown still shows horrible indentions and bumps. I have my sisters wedding in a month and I just want a smooth forehead, what can I do?? Thanks.

Doctor Answers 10

Forehead bumps

It does look like there is some improvement, but it is difficult to tell since the lighting is different between the two photos. I usually do not see a maximal affect from botox for at least 2 weeks, so if you recently had the injection just give it some time. By the time you go in for your next visit you may very well be a lot happier. One thing that I would have probably done differently is use a different filler material in the forehead. I like the thinner products when trying to fill in lines directly instead of creating lift. Restylane silk or Belotero may be ones to consider in the future.

Best,

Dr. Sarah Saxon


Dallas Otolaryngologist

Treatment of significant forehead lines

 Thank you for sharing your question. You do have improvement following your treatment with BOTOX and Restylane. It appears you need additional treatment. Perhaps additional Botox and/or filler is required.  See an expert in person for comprehensive evaluation and discussion potential options.  Good luck,

Forehead

Thank you for posting your photos. It looks like you have had a pretty significant improvement in the forehead, but may need additional treatment. If you still have muscle movement, additional botox may help. Otherwise, the only other option would be additional fillers.  Please make sure you are seeing a board certified dermatologist or plastic surgeon who is very skilled in injections.

Also, Botox wears off after 4 months. As your lines are very deep which is likely because the muscle is very strong, it is best if you get to an optimal dose of botox and keep if fresh by getting it re-injected as soon as the muscle movement returns.  If you do this, the lines will continue to recover and diminish.

Persistent forehead lines

Your forehead does have persistent creases. Although there is some improvement, I can see why you are frustrated. The thing to remember is that Botox only lasts for 3 months. When you have deeply etched lines in your skin from such powerful muscle contractions over many years, it will take consistent repeated Botox treatments to fully erase the creases and smoothen out your forehead skin. I would predict that three treatments spaced regularly at 3 month intervals would get you the result you are seeking- that essentially means 9 months of not being able to make the creases. In the short term, additional filler can soften these lines for the wedding. All the best!

Matthew Brace, MD
Ontario Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Botox and juvederm

It looks like there has been a little improvement.  It's likely that some more Botox and Juvederm, appropriately placed, can fix this.  However it's very difficult to tell accurately from just photos.  Your best bet would be to speak to an experienced practitioner who has done many injections.

Reza Tirgari, MD
San Diego Physician

Botox results

Thank you for your question jxtreme22. I am sorry to hear about your situation. Botox is a purified protein used to address wrinkles associated with facial expression. It is difficult to assess your results with these photographs as the lighting is significantly different. Also, it is important to examine the areas with facial expression. This tells us whether the wrinkles are caused by or exacerbated by muscle contraction. If so more Botox may provide further improvement in these cases. If not alternative modalities may be considered. Please follow up with your doctor for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 1 review

Forehead rejuvenation

Thanks for your question. The B&A photos you posted were taken under very different types of light, so it is hard to say if the after looks different for that reason. You likely would benefit from a combination approach of Botox, surgical subcision (if some areas are bound down like a scar), and also filler (maybe Juvederm Voluma). What you really need is a face to face consultation with a physician injector who is well trained and experienced treating this sort of problem. I strongly believe that just one type of treatment will not solve this problem for you, and you will require a blended approach. Best of luck to you!

Alix J. Charles, MD
Hinsdale Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

The Forehead Smoother--Fillers, Botox, Subcision

There is some improvement in your before and after pictures. It may be that a touch-up is needed. Fillers work great in this area with or without subcision and can be combined with Botox for improvement.  Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Forehead problem

this is a bit complicated and you should be sure you see a board certified dermatologist or plastic surgeon. it is difficult to tell from the photos but it looks like some areas are bound down and can be loosened with subcision and then filler into the indentation. it has be done properly because there is the risk of slough in this area

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

Need a follow-up appointment

I think if you return for a follow-up appointment the Doctor can easily make your forehead better with a filler treatment to that area.  Just as you said Botox and filler are often needed to optimally fix an irregular forehead.

Kenneth Oleszek, MD
Denver Internist

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.