Effective Treatment for Frown Line - Filler or Botox

I am only in my early 30s and rest of my face is wrinkle free, but the frown line between my eyebrows are so deep. These are not two lines, they look like two deep holes if it makes any sense at all. My doctor has suggested that I try botox with some filler. I was surprised as I only heard of using botox alone to treat the lines between eyebrows. What kind of filler should be used?

Doctor Answers 4

Botox and/or fillers for frown lines

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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.

Glabella lines - frown lines between the eyebrows

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Botox works by paralyzing the muscle that moves the skin. You can simulate its effect by moving the skin on either side of wrinkle away from the wrinkle with your fingers. If the line does not go away completely botox alone will not work. In such cases a filler is also required for the line/wrinkle. Deep frown lines between the eyebrows are particularly problematic because the blood vessel supply to the skin is easily compromised by injectable fillers. That does not mean that should not be done. It means extra care should be taken to prevent skin loss as a result of filler injection.

As to what the wrinkle should be filled with - that depends on who your doctor is. Different doctors prefer different fillers.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.


Aaron Stone, MD
Los Angeles Plastic Surgeon

Very deep frown lines usually require both botox and a filler.

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Very deep frown lines between the eyebrows usually require boto/Dysport ($300) and a filler such as Restylane/juvederm/or Radiesse($550-650).  Permanent implants have also done great to give a permanent improvement for deep grooves and are easy to put in under local anesthesia for around $1500.  Good Luck,

David Hansen,MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Botox and fillers for frown lines

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I use Botox as the primary treatment for the frown line. i two weeks,once the muscles are not working but there is persistence of the lines, you can have some filler - whichever you like- injeceted for maximal improvement.

Morad Tavallali, MD, FACS
Vienna Plastic Surgeon
4.7 out of 5 stars 30 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.