How much could Juvaderm help with deep creases between the brows (without using Botox)? (photo)
Doctor Answers 12
How much could Juvaderm help with deep creases between the brows (without using Botox
It is terrible that you have had serious issues with Botox in the past. Optimal therapy in this area would be a combination of toxin and filler. It is an off label use for Juvederm and would have to be done by a board certified dermatologist with a great deal of experience in this area. Additionally, you could do Thermi Rase which disables your nerve endings so you cannot frown, but you will still need to have your Juvederm done. This will eliminate the need for Botox. Good luck, Dr. Downie.
Filler between the brows
Hello! Thank you for your question, and for sharing your pictures. Generally speaking, when patients present to my practice with a forehead like yours, I do a two phase treatment: Botox for 6-9 months, followed by filler after the muscle has had time to atrophy, or shrink. If you cannot use Botox, filler can be used to correct that problem, with two caveats.
(1) Filler will not last as long without the paralyzing effect of the Botox, and
(2) This area of the face has several arteries which can be damaged by filler injection.
Make sure that if you do proceed with filler in your forehead, that you choose a reputable practitioner who has experience injecting in this area.
Treatment of deep glabellar creases
Your photo suggests that you have brow ptosis/drooping and intact action of the procerus and corrugator (frown) muscles. Deep creases are chronic dynamic wrinkles, and - in that area - related to the heavy frontalis and brow tissue and hereditary facial features. Filler is NOT a good option for several reasons:
1) it would add to the bulk of the tissue,
2) it is a high risk area for injection because of neurovascular bundles
3) the creases are chronic and deep.
Surgical brow lift combined with CO2 Laser skin resurfacing would help the heavy glabellar area, but it is not realistic to expect a complete resolution of these wrinkles. You may want to see an Oculoplastic surgeon for evaluation and treatment. Best wishes for improvement.
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How much could Juvaderm help with deep creases between the brows (without using Botox)?
Deep crease between eyebrows
I am not sure what your complication was from the Botox. Generally I would use Botox first in the area to relax the muscles and then a month later would conservatively inject Juvederm to fill the residual crease. Juvederm is not approved for this area because there are large blood vessels under this area that if the filler was placed in them could cause serious complications including loss of tissue. The other option would be surgically severing these muscles which would be more permanent. You need to see a oculoplastic/ facial plastic or plastic surgeon to get an evaluation in person to pick the best option for you.
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