Will Botox Help Large Crease in the Middle of Forehead?

I have a huge crease in the middle of my forehead. Will botox help or work, or do I need actual plastic surgery??

Doctor Answers 9

Large cresed in forehead and reacltion to water beast.

If this crease is present at rest, it is not lkely the botox will be of any benefit. If, however, ti is aggravated by muscle activity or expression then botox could be of great value.

Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

BOTOX can be used to soften the crease in the middle of the forehead

BOTOX can be used to soften the crease in the middle of the forehead. I don’t like to use too much BOTOX in the forehead because that can cause the patient to be expressionless. Sometimes I use BOTOX in addition to using a filler (like Juvederm) to treat the creases in the forehead. Combining these products can often work better than BOTOX alone.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 66 reviews

Large vertical indentation in the forehead

Your photograph shows a large indentation oriented vertically  in the forehead, mostly midline. It is somewhat tapered in shape. If this was acquired from a traumatic incident then you can inquire about fillers as Botox would not help.  There is a risk though that fillers could compromise the blood supply in this area and you could develop a large area of dead skin (necrosis) which can lead to further scarring, and it would be a wider area than what you have now.  If you did not have any trauma there, and acquired this during your adolescence or adulthood, it could represent a localized form of a scarring condition called, en coup de sabre, or linear morphea. Before any fillers would be used, you should consult with a board certified dermatologist to analyze your situation.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Central vertical forehead depression

I also would agree that soft tissue augmentation would be your best bet.  Is the overlying skin normal?  An eval by a cosmetic doc would be necessary to rule out any other rare dermatologic or localized fatty tissue abnormality/disease.  If it really is just a vertical dent, then you could use a simple, temporary fix like restylane or juvederm or radiesse.  That would have little to no down time, and could give you an idea of what it could look like with correction.  Fat transfer could be done later, or instead of the filler, as an alternative.  More volume is available with fat, and the results are permanent.  Just more of a procedure to get correction.

Kevin Robertson, MD
Madison Facial Plastic Surgeon
4.7 out of 5 stars 14 reviews

Botox Not Likely to be Very Helpful

The midline crease/ indentation in your forehead looks to be much more involved than a crease caused by muscle activity.  A thorough physical examination is required before and exact cause and hence a treatment can be established.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 reviews

Large crease in the middle of forehead

Thanks for the photo. Is this a genetic deformity or traumatic? My recommendation is a combination of Botox (Dysport) + fillers. If there is an improvement that is satisfactory with you than I might use fat grafting or dermal fat strip to fill in the indentation.

From MIAMI Dr. B

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Will Botox Help Large Crease in the Middle of the Forehead?

Hi Marcus,

Your cosmetic physician should examine your forehead to determine the etiology of what is the cause of your large forehead crease.  It looks like an indention from past trauma, in which case a filler will help.  If it is caused by abnormal musculature not before seen in the recent history of mankind, then Botox would help.  So it depends on the cause of your big forehead crease whether Botox would be helpful or not (me thinks not as Shakespeare might have said).  Though, Botox could calm down that furiously happy pose you have struck in your photo.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Juvederm or Restylane (not Botox) will help forehead indentation.


You have an indentation that can probably be made much better with an injectable filler like Restylane or Juvederm.  Botox only relaxes muscles, and won't help you.  

Fat transfer also works.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Forehead wrinkles

I would typically suggest Botox before going to plastic surgery. if it doesnt work to your satisfaction, then you would be more assured that plastic surgery is a viable alternative. If it does work, then you would have to repeat Botox at 3-4 month intervals to maintain the response.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 4 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.