I have a single, static frown line between my brows at rest. I do not frown during the day, and wear tape over the lines at night to prevent me frowning as I sleep. I understand I will need a dermal filler to plump out the folded skin. My question is, in my case, what is the point of having Botox as well as the Dermal filler? It seems like Botox will be a waste.
Dermal Filler Without Botox - for Frown Lines?
Doctor Answers 17
Even though you have a static wrinkle and wear the tape at night, the reason the wrinkle formed in the first place is because of the muscle movement. Most people have a baseline muscle tension or contraction that they are not aware of that makes them furrow if they have a a wrinkle that you are describing. While the filler sounds like what you need to make the crease go away at this point, the Botox will keep it from coming back more quickly. Over time it may prevent you from needing fill at all, as stopping the muscle is really getting to the root of the problem.
Hope that helps explain the rationale!
In my experience, superficial lines at rest in the glabellar area will disappear over time if you keep the area tightly controlled with frequent Botox or Dysport injections at appropriate doses. This typically means injecting the area every three to four months to keep the muscles as quiet as possible. I typically reserve the combination of Botox or Dysport with filler injections for deeper lines or for someone who is in a hurry for the lines to disappear for a special event.
Web reference: http://www.dorsetstreetdermatology.com/cosmetic-dermatology/botox-dysport/
Often a combination is suggested because: If the line is worse when you move the muscle, then Botox will stop you from being able to do this (i.e., stop the dynamic movement that's creating the static line). Then you have the static line filled in (please visit a good, board-certified injector for this as facial anatomy in this area is key!).
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Adding Botox to that area will help to diminish the line. There are muscles on either side of the line that push the skin together. Botox is usually my first choice, adding filler only if the line is too deep to be overcome by Botox alone.
these work synergistically in the right patients. Botox will correct the underlying dynamic muscle movement and filler , if appropriate will elevate the folded frown line skin. The treatment of choice for glabella lines is botox with dermal filler used secondarily.
Thank you for your question. The frown lines between the brows can be address two different ways:
1) Botox or Dysport can be used to soften the deepening of the frown lines when making a frown expression. The treatment may even soften the lines that are present at rest.
2) Restylane or Juvederm can be used to soften the frown lines that are present even when you don't make an expression.
For someone who has concerns with both the static lines (without expression) and the dynamic lines (with expression), then using both products would work well together.
I often find that patients who return after a Botox or Dysport treatment in the frown areas complaining it didn't work, is due to the confusion between the static and dynamic frown lines. They continue to see the static lines even though the dynamic lines have softened considerably.
1) Botox or Dysport can be used to soften the deepening of the frown lines when making a frown expression. The treatment may even soften the lines that are present at rest.
2) Restylane or Juvederm can be used to soften the frown lines that are present even when you don't make an expression.
For someone who has concerns with both the static lines (without expression) and the dynamic lines (with expression), then using both products would work well together.
I often find that patients who return after a Botox or Dysport treatment in the frown areas complaining it didn't work, is due to the confusion between the static and dynamic frown lines. They continue to see the static lines even though the dynamic lines have softened considerably.
At this point, you definitely need a dermal filler to plump out the crease across your forehead. However, that crease was etched in your skin by ongoing muscle contractions of which you’re likely unaware. It is this constant movement – while awake and asleep – that causes the furrow. So if you merely fill it up, without restricting the muscle movement, the furrow will only return and deepen. Botox injections every 3-5 months will keep your brow smoother longer and reduce the severity of the line when it starts to reappear. That, in turn, will make less filler necessary.
Lines in the glabella (between the eyebrows) are caused by movement. A neurotoxin, such as Botox, Dysport, or Xeomin is almost always indicated in this area to relax lines. Occasionally, lines can be so deep that they are present even after the neurotoxin is working. In this case, an additional superficial injection of a hyaluronic acid (juvederm, restylane, or belotero) can be a good choice. This is an off-label injection that should be performed by an experienced cosmetic dermatologist or plastic surgeon. There are risks when injecting filler in this location, which should be discussed prior to treatment.
Frown lines develop from muscle contraction whether you are aware of it or not. Before Botox, we would fill the lines with filler, but the muscle action would tend to force the filler out. After Botox, we paralyze the muscle first and inject the filler a week later if convenient in a perfect world.
If the wrinkle is soft and pliable in the early stages, a filler may work very well. If the wrinkle is very deep etched, save your money. Fillers are disappointing, but the Botox may prevent it from worsening.
Web reference: http://www.youtube.com/VillarPlasticSurgery
A dermal filler can fill the line, and, if put in the dermis beside the line, stiffen the area so that another line does not form readily there. However, the filler does not address the underlying cause of the line which is function of the muscle below it. Even if you do not think you frown during the day, you do. The tape you place at night also will not keep the muscle from working and the skin from wrinkling. The only thing that has been shown to prevent the lines from forming is Botox. Therefore, the main treatment for these lines is Botox. If, when you are relaxed, you have no lines, then you need nothing else. However, if you have an indelible line that does not go away when you are relaxed, you need the filler
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.
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