My forehead ridge creates a crater on my forehead, makes my brows look extremely heavy. How can I fix without extensive surgery?

Question

Would Botox work to minimize? Is filler a better option?

Jason Emer, MD · Answer

To give the eyebrows a nice lift, we use injectable fillers to improve the eyebrow, upper eye, forehead and temple. A filler is placed on the bone and in the fat pads of these areas to contour and lift without it looking overdone. We use cannulas to limit pain and swelling. I suggest getting a formal consultation with a facial sculpting expert.

Toby Mayer, MD · Answer

Using the Irregular Trichophytic Forehead Incision for removal of Large brow bone.  this is a procedure I invented more than 40 years ago to reduce the brow bone  with or without a Forehead lift. I have done hundreds of these with only 1week downtime for social events. You can be doing work at home the next day and could go out with a hat. The corregator muscle can be divided as well but your problem is mainly the bone. See several FFS surgeons and choose one that can show you dozens of results without a scar (Hairline) and natural appearance.  Do not rely on Imaging.  Your problem cannot be corrected with fillers or Botox.

Gregory A. Buford, MD, FACS · Answer

With sufficient dosing of either toxin, you should be able to shrink these muscles down over time.  The same approach has been used sucessfully for years in reducing masseter muscle fullness.  I would start with at least 24 units and increase from there.  You may require a good amount of the product to accomplish this but it certainly can be done.I hope that helps and wish you the very best!Warmest regards,-Gregory A Buford MD FACS PCEOBoard Certified Plastic Surgeon and AuthorCertified National Allergan MASTER Facial Injectables Trainer

Shaun Patel, MD · Answer

I would recommend a neuromodulator like Botox or Dysport to relax the glabellar muscles to begin with. Regular treatments should reduce the size of these muscles. If there is any forehead volume loss, it could be treated with an HA filler.

Shelin Tkatch, MD, FRCSC · Answer

In the pictures it appears that you have very strong corrugator muscles. I would start treatment with neurotoxin (Botox/Dysport/Xeomin) and see what degree of improvement you obtain once the muscles atrophy or shrink. If this does not bring adequate improvement I would suggest you consult an experienced facial surgeon who can discuss surgical options. I would not recommend trying to fill the "crater" with filler. Best regards, Dr. Tkatch

Ken Dolynchuk, MD · Answer

Thanks for your question and photos. I would have to feel the ridges and perhaps order a CT. But if this is a frontal boss then really the only solution is to abrade them or reconstruct the frontal bone. I doubt that your muscle is the cause of this much elevation. So Botox shouldn’t work. If you fill the hollow your ridge will become even more pronounced. Seek a consultation with a craniofacial trained plastic surgeon for further details. Hope this helps.

My forehead ridge creates a crater on my forehead, makes my brows look extremely heavy. How can I fix without extensive surgery?

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