Do not want to use fillers, only Botox, for permanent frown lines. Is it possible?

I have been injecting Botox for dynamic wrinkles (wrinkles related to the movement of the muscles of facial expression) since 1991. Clearly, Botox (as well as Dysport and Xeomin) work well for softening the overactivity of the facial muscles that accompanies the passage of time. Since there is often a certain degree of static tension in these muscles (i.e. excessive contraction even at rest) resulting often in some overlying wrinkling, these muscle relaxing agents can be of help, to a certain degree, with some static wrinkles, as well. Having said that, it is important to understand that years of motion of the underlying muscles eventually leads to permanent surface wrinkles at rest, just the way folding a piece of paper leaves a permanent etched crease that evening ironing would be hard pressed to entirely remove. What this all means is that if your surface wrinkles have been around a long time and are deep, the Botox treatment may be helpful, but there may still remain the need to address the residual "etched in" lines with a filler. Belotero Balance, which spreads easily and possesses little to no tendency to give rise to the unwanted, bluish Tyndall Effect when injected superficially (as is necessary for elevating etched in lines) would be my first choice in my Upper East Side Manhattan office. (In my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available, I would opt for Teosyal Redensity II). I have been injecting fillers in the frown line area (glabella) for over three decades, since the early days with the use of the original Zyderm I collagen filler. It takes only small amounts of material, injected quite superficially to achieve very gratifying results. So, perhaps this will make you feel more at ease regarding filler use.It is important that you seek consultation and treatment at the hands of a board certified aesthetic physician with experience and expertise in the use of neuromodulators and fillers. And before proceeding, make sure to ask to see his/her before and after photos. Best of luck to you.

Starting Botox would be a great idea. Your muscles relax with the use of Botox therefore, the appearance of those static frown lines will improve. Botox typically lasts about 4 months. I always tell my patients if you are consistent with your treatments every 4 months the weaker your muscle will get over time. If your desired results are not achieved a thin filler such as Belotero can be used to soften your frown lines in addition to the Botox.

Yes, Botox will help eliminate frown lines.  Those lines are in an area referred to as the glabella, and are a result of the action of a muscle called the corrugator supercilii when you frown. This is the area that Botox initially gained FDA approval for cosmetic use.  

Botox is for dynamic wrinkles, which are those that appear when you make facial expressions. Once you’ve got static frown lines, Botox is far less effective at rejuvenating your appearance than fillers. However, it may still result in a bit of an improvement, although it would be difficult to say by how much. You could start with Botox to see if you like the results. With repeated treatments, it may even help the area by preventing your current static wrinkles from getting worse.

Yes, Botox can help the frown lines between the eyes. If performed regularly, over years, the skin will remodel and that will help to improve or even eliminate the lines. It does take regular Botox treatments and a year or more, but you can get great improvements if you are patient and persistent. See an experienced injector.Andrew Campbell, M.D.Facial Plastic SpecialistQuintessa Aesthetic Centers

Botox shows a significant amount of improvement to this area. Skin improvement with microneedling/PRP and lasers also help. Sometimes fillers are needed to get the final improvement. I suggest consulting with an expert for evaluation. Best, Dr. Emer