Should I use botox or fillers for frown lines? Will botox help give a lift there?

I was also told to use botox on my neck bands and it will help lift jowels. Am I getting accurate info. (I was informed of swallowing effects.) Thank you!

Doctor Answers 11

Options for frown lines

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. The effects typically last 3-4 months depending on the dose. I generally use between 15-40 units of Botox (30-120 units of Dysport) in the frown area depending on the strength of the muscle and the degree of frown reduction we are trying to achieve.
2) Restylane or Juvederm can be used to soften the frown lines that are present even when you don't make an expression. This can last for a year or more when used in conjunction with Botox.
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.

I would not suggest you use Botox to lift jowls, but it can reduce the neck bands - particularly the vertical ones.

Fillers or Botox

Botox can relax the masseter muscles which would soften the jawline, but if the jowls are prominent and there is excessive sagging of tissues along the jawline, then fillers may be more suitable. Severe cases require surgery (facelift). Neck bands may be treated with Botox.

For frown lines, Botox can help and fillers may be suitable if the lines are visible when your face is in a neutral expression.

Use Botox for right indications.

Botox for frown lines... YES! Botox for Jowls... NO! Botox for neck bands...NO...unless you have unlimited funds.  Camouflaging your Jowls with fillers in front or along the jaw line works well.Sometimes, if your frown lines are still present after totally immobilizing the "frowning"  muscles, then a tiny thread of a HA filler may be indicated.

Manuel M. Pena, MD
Naples Plastic Surgeon
4.0 out of 5 stars 4 reviews

Treating frown lines

Depending on the depth of wrinkles at rest and movement, Botox is generally your best starting point for the frown lines ("11s"). If there are etched in wrinkles present at rest without any movement, then adding a filler in addition can be worthwhile. Botox for neck bands can be helpful, and injecting Botox into the jowls themselves can reduce their appearance by shrinking the submandibular gland below it. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Benjamin Barankin, MD
Toronto Dermatologic Surgeon
4.9 out of 5 stars 42 reviews

Botox or fillers?

Around the mouth I prefer the use of fillers, in the forehead area I prefer the use of Botox. In the neck area I prefer either surgery or Fraxel Laser. However, everything is adjusted to an individual patients presentation and needs. None of this is absolute and can be changed to get the best ,most natural looking, and longest lasting results.

Lines and botox

I think Botox/Dysport are great for glabellar lines,forehead and crows feet.I do not use them for neck bands.I think if you have prominet neck bands then a necklift would be more appropriate.

Robert Brueck, MD
Fort Myers Plastic Surgeon
5.0 out of 5 stars 53 reviews

Should I use botox or fillers for frown lines? Will botox help give a lift there?

Botox will help soften lines on the forehead, depending on how strong your muscle movement will determine how many units you would benefit from. If your wrinkles are very deep to start, it may require a few rounds of Botox to smooth out the lines, up to 2 yrs of regular injections. I don’t suggest having a hyaluronic acid filler injected because it could possibly cause a blockage to the blood vessels in that area. Seek a reputable injector who can give you an honest opinion and provide you with the result you wish to achieve.

Botox for Frown Lines and Neck Bands

Botox will relax the muscles that cause both frown lines and neck bands. In the brow you will get some lift of the brow from the botox, and in the neck, the bands will smooth out but that may or may not alleviate the jowls, which have other causes aside from the neck muscles. Fillers such as juvederm may be cautiously added if the frown creases are deep, but complications from fillers in that area are possible.

Stephen Mandy, MD
Miami Dermatologic Surgeon
4.3 out of 5 stars 6 reviews

Best treatment for frown lines? Are fillers helpful there as well?

Botox is, without question, the go-to option to improve glabella lines. However, some people have deep imprinted lines and require both Botox, to relax the muscle, and filler, to fill the imprinted lines. Regardless, Botox is the first treatment in most cases. Appropriate treatment of the corrugator muscle there should also give the inner portion of the eyebrow a subtle lift as you asked about.

Fillers like Restylane for Frown Lines in the Glabella

Treating the glabella creases (vertical frown lines between eyebrows) may require both a filler (Restylane/Juvederm) and a paralytic (botox/dysport). The paralytic agent stops you from making the expression that caused the lines in the first place. If you don't have any lines when not making that mean face, then all you will need is Botox or Dysport. Either of these products work great and if you use them regularly you might never get creases at all. This is why I suggest people start with Botox/Dysport in their 20's. But if you are a little late to the party, then your creases may need to be treated with a filler like Restylane. The Restylane will fill the crease for a partial instant improvement but more importantly it will cause collagen growth in the area which (along with relaxing the muscle) may completely correct even deep creases over a few months. The collagen will persist well after the Restylane itself has dissolved. In fact, it may last indefinitely if you continue to use a Botox or Dysport. Even extremely deep glabellar creases may be completely fixable using that combination. In summary, prevent the crease with Botox/Dysport, repair the crease with a filler like Restylane or Juvederm.

Your neck banding may improve with a paralytic. This is an affect that works better on some people than others. It generally requires a higher dose of Botox or Dysport. Certainly it is possible to cause swallowing issues, but that would be very unlikely if the injector knows the proper location for injection. The swallow muscles are quite a bit deeper than the muscles that cause the banding. I truly doubt you will have any correction of jowls using Botox/Dysport in the neck.

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
4.9 out of 5 stars 28 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.