How Are Juvederm and Botox Used for Brow Wrinkles?

What are the main difference between Juvederm and Botox for treatment of wrinkles between the brows? Are they used together? What is the benefit of combining them? How much is used of each?

Doctor Answers 18

Botox, Dysport, Juvederm and Restylane can be used for wrinkles between the eyebrows

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Botox and Dysport relax the muscles that cause the wrinkling in the first place. They take minutes to perform and usually last 3-4 months before repeat treatments are needed.  Juvederm and Restylane are hyaluronic acid filler substances which can be injected directly into the skin to fill in lines and folds.  They are used in the wrinkles between the eyebrows for patients who have a deep crease, that is still present even when they are relaxing their muscles.  Both Dysport and Restylane can be used at the same time to give longer lasting results to patients who have a visible crease between the brows.  Be sure to seek a board certified Dermatologist who is an expert in fillers and relaxers to treat your skin.  Best to you.

Chicago Dermatologic Surgeon

Botox and Juvederm.

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Botox stops the movement of muscles so you cannot frown.  Juvederm is a filler that is injected into the skin to plump up areas that have lost volume.  If needed, they can both be used for frown lines.  The amount required depends on the individual, how strong their muscles are and how deep the lines are.

Martie Gidon, MD, FRCPC
Toronto Dermatologist

Botox vs. Restylane or Juvederm for glabellar folds / creases / wrinkles

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The number one treatment, by far, for glabellar furrows, is Botox. These are mimetic lines, in other words, lines or wrinkles of the skin that are present from underlying contraction of muscles.  Usually the muscles have been doing this for years before the wrinkles form.  If the muscles are relaxed by Botox injections then the wrinkles start to fade. One might have to keep up with Botox and repeat before it's all worn off in 4 months, so that the skin maintains its smooth contour and the creases will continue to improve.  Stubborn folds or impatient patients, can benefit from the addtion of filler to the folds.  In this anatomic region, though, one must be very cautious not inject too thick a filler as there have been cases of necrosis (death of the skin or ulceration) with possible scarring.  Small amounts of Restylane or Juverderm Ultra, not Ultra Plus, can be done a week after the Botox (sometimes the same day if the filler is done first).

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

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Botox and Juvederm to treat brow furrows

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My preference is to start with Botox to paralyze the brow depressor muscles first.  If there are still depressions between the brows after the Botox has taken effect, Juvederm is used to fill in the remaining depressions. While the Botox will last for 3-4 months, the Juvederm will stay for 9-12 months. Generally about 20 units of Botox are used for the brows and one syringe of Juvederm is plenty for the brow area.

James McMahan, MD
Columbus Plastic Surgeon
4.8 out of 5 stars 40 reviews

BOTOX® Cosmetic prevents deepening of lines. Juvederm fills the existing line.

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These products are great to use together. Botox will relax the muscle that was creating these creases and causing them to get deeper over time. 1 syringe of filler will immediately plump up the lines restoring you skin's natural volume. If you maintain your botox regularly every 4-5 months, you may never have to do filler to that area again.

Manish Khanna, MD, FRCP(C)
Montreal Dermatologic Surgeon
4.6 out of 5 stars 27 reviews

Botox and Juvederm for 11's

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Sometimes when the patients come for Botox their 11's are so deep they have already formed scars between the brows.  The first step is to stop those two large muscles from continuing to pull down into this area.  If one starts with filler and no Botox the filler typically resorbs sooner.  Remember, Botox is preventative as well so should definitely be continued.

On first time patients, I recommend Botox first with a follow up visit approximately 2 weeks later.  If deep wrinkles are still present then filler can be considered.  Botox is then continued every 3 months.  Good luck!  vargasfaceandskin

Hannah Vargas, MD
Kansas City Facial Plastic Surgeon
4.8 out of 5 stars 48 reviews

Juvederm vs Botox for brow wrinkles

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Treatment of the glabellar region of the forehead is the most common indication for Botox injections and is the best "first choice" as treatment in this area. In many patients these lines can be quite deep and remain prominent even at rest (called static lines). In this circumstance I will usually recommend that either Juvederm or Restylane be injected at the same time as Botox to give a quicker and much more significant improvement. Also, at any time after Botox injections if the lines still appear to be etched into the skin I will recommend injecting a filler such as Juvederm or Restylane to get a better result.


Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Glabellar frown lines treatment

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At the Toronto Dermatology Centre, we usually prefer to start with Botox treatments for the dynamic glabellar frown lines.  Sometimes, a filler such as Juvederm can be used for deeper lines not responding to adequate Botox treatments

Anatoli Freiman, MD
Toronto Dermatologist

For forehead wrinkles use botox/dysport first

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When it comes to treating lines across the forehead and between the brows I think that bottom or dysport should be used  alone before doing anything further. Most of the time this will be all that you need. Some people will inject a filler if there is still a problem but be careful who you have do this as there is more risk involved and you want the injector to be very well trained. 

Jo Herzog, MD
Birmingham Dermatologist
4.8 out of 5 stars 20 reviews

Botox and Juvederm best used in combination

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What you need depends on what is there!  If there are no lines at rest, then Botox alone will prevent the development of glabellar wrinkles.  However, if you didn't start using Botox soon enough, or if the glabella has not been relaxed consistently, actual wrinkles may have developed.  Wrinkles are like scars in the skin.  Constant movement in this area can cause areas of tissue loss, seen as furrows.  I always recommend doing Botox first, to relax the area, then injecting Juvederm a few weeks later, after the muscles are completely relaxed.  This prevents creasing the filler - so whenever filler is put in, a neurotoxin should be used as well.  If the muscles are consistenly relaxed and the area is kept filled in, the wrinkles will eventually remodel and become less and less noticeable with time. 

Laura E. Skellchock, MD (in memoriam)
Boca Raton Dermatologic Surgeon

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.