Recently a plastic surgeon injected 100 Dysport into my forehead and .05 of Restylane into my nasio folds, corners of mouth, and line under chin. I saw NO results with Radiesse. Very little results with Dysport, which is odd because in the past I had better results with less than 75 injected - and in the past my forehead felt heavy afterwards, but not this time. I went back to the doc and he said that I would NEVER be able to get rid of my fine lines with fillers. Is he correct? I am 36.
Is It True That Fillers Won't Work on my Fine Lines?
Doctor Answers 12
Fine lines can be treated with a combination of botox or dysport and fillers
Fillers for Fine Lines
100 Units of Dysport should be more than enough to treat your forehead so something is not right. You also said Restylane and then called it Radiesse. At your age, it would be unlikely that your fine lines cannot be treated. I recommend you get another opinion from an experienced physician injector.
Dysport/Botox - Is It True That Fillers Won't Work on my Fine Lines?
There may be some truth to that.
Fine lines can be very difficult to treat - and I generally prefer Dysport or Botox for fine lines at or above the level of the eyes (I use fillers for the areas below that). So I'm not sure that any filler (whether Restylane, Juvederm or Radiesse) is the ideal treatment for fine lines, wherever they are.
You may want to consider a series of light peels in addition to Dysport or Botox. Hopefully, that combination will be effective.
I hope that this helps, and good luck,
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Fine lines and fillers
Forehead lines that have been there a while may not be gone as easily as you might think. I tell patients that some lines are like letting down an old hem. You have to wash and iron the dress or pants a few times before the line is gone. Certainly didn't skimp on the quantity used.
Forehead lines can be trickier than expected with Dysport, Botox, or fillers.
LWS, this is an interesting question. Forehead lines are not always so easy to eradicate with just Botox or Dysport with or without fillers. Some people have such long foreheads and rely so much on their forehead muscles to keep their eyebrows up for normal living and conversation, that the amount of Dysport or Botox needed to truly smooth the lines will drop the brows too low, make the forehead feel heavy, and make the patient unhappy. A lighter dosage may make the forehead not feel heavy, but may be less effective at smoothing because the patient is still using the muscles to lift the brows. In these cases, it is unfortunately accurate to say that Botox or Dysport alone may never really be able to correct the lines, and sometimes a surgical brow lift is the only option to consider.
Filler carefully placed in some of the forehead horizontal lines may help modulate the situation, but this use is tricky since the filler has a higher risk of showing if placed too superficially. You need a careful, truthful, and comprehensive evaluation with a board-certified dermatologist or plastic surgeon who are really watching your natural expressions and muscle use and calculating that into your evaluation.
Fine line filling options
Most fine lines can be improved by the careful (intradermal) superficial placement of Restylane in the line. In fact, I use this technique for forehead lines combining with moderate doses of Botox or Dysport to reduce horizontal forehead lines.
Fillers can fight fine lines!
Most fillers available in this country are geared to medium to deep lines. Nonetheless, experienced dermatologic surgeons and plastic surgeons know that we can dilute our products off label by mixing them with some anesthetic to reproduce the fillers available in Europe. We can make a product which is very similar to Restylane fine line which is wonderful for finer lines. Both Restylane and Juviderm in experienced hands can work wonders!
Fillers work for fine lines
We have found that most fine lines can be filled with either Restylane or Juvederm by injecting the product through a very small needle. Botox or Dysport are often needed as well in areas where lines are created by muscle movement such as the forehead, frown, and crows feet.
Diluted Fillers Work Well for For Fine Lines
Fine lines in the crow's feet area, between the eyes, across the forehead, and even the "necklace lines" that ring the neck are indeed amenable to fillers, as are the etching-like lines resulting from years of facial expression that sometimes persist even after the use of Dysport or Botox.
In Israel, Europe, and Canada, where whole product lines of fillers have been approved by their respective regulatory agencies, there are products available, such as Restylane Fine Lines, specifically formulated for treated superficial wrinkles. In the United States,these fillers have unfortunately not yet received FDA approval.
To overcome this limitation, fillers (my favorite for this purpose being Juvederm XC), appropriately diluted with lidocaine, a local anesthetic, have proven quite beneficial for superficial lines and wrinkles as a solo treatment or in combination with a neuromodulator, like Dysport.
Fine Lines~Fillers, Dysport or ?
It would be unusual to not see any effect from 100 units of Dysport in the forehead. I would definitely consider trying Dysport again before you give up hope of it helping with the dynamic lines on the forehead. Fillers for fine lines and wrinkles can generally make a nice improvement. If the fine lines you are looking to correct are more like a crease you would see in paper after folding it as opposed to an indented area then a filler won't really do the job. Lines such as these need to be addressed with laser resurfacing, chemical peels, topical retinoids, etc. to help buff out line.
Dr. Grant Stevens
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