I am 29 years of age and I have more forehead lines than anyone else I know. I tried Botox, but I didnt like the look that it gave me. I also tried doing the YAG Erbium laser resurfacing, which didn't do much for that problem. I live in Chicago but I'm willing to travel in order to have this done. Can one of you please recommend something for me?
Juvederm for Forehead Wrinkles?
Doctor Answers 9
There are other options to consider if you didn't like the Botox results
Because you did not like the results of Botox and laser resurfacing, other treatments you may want to look into are Juvederm, Restylane, Radiesse and Fraxel repair laser if you have type 1-3 skin.
Uusally forehead wrinkles are best treated with Botox. Treating deep lines with filler maybe beneficial but I would try Botox first and see how it responds.
Juvederm for forehead lines? Not the best option
Being that you are still very young, your forehead lines/wrinkles need to primarily be addressed by realxing the muscle contraction that is causing the lines. Laser resurfacing helps improve the texture of the skin; however, it is still the underlying problem of muscle action that is leading to the lines that you are chasing after. The same concept would apply with using Juvederm - it is not addressing the underlying problem.
With that said, we agree with what the many panel members recommended which is to give Botox or Dysport another try with a different practitioner. Without knowing what you specifically did not like about your Botox treatment, it is difficult to determine what could be done differently. There is definitely an art and technique to using Botox, and we encourage you to give it another try. It would be the most cost effective and simpler treatment option for your goals.
Refer to the below link for a discussion on Botox treatments for the forehead area.
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Using Juvederm in a forehead
Juvederm is an excellent hyaluronic acid based injectable that can be used effectively for facial contouring.
Juvederm is commonly used around the lips, the smile lines, the marionette lines, under deep wrinkles, under deep scars, and in the fine lines of the forehead.
In our practice, we commonly treat the forehead first with Botox to help relax the muscles that are creating these deep wrinkles. If the patient continues to have deep furrows after Botox, a small amount of Juvederm will usually correct this.
Juvederm not good choice for forehead wrinkles.
1) In our experience, for almost everyone, forehead lines are greatly improved with Botox. But it has to be done just right, and you have to use enough of it. I recommend trying Botox again with another plastic surgeon or dermatologist.
2) In the rare cases when fillers in the forehead are needed, we use Restylane. But we use it together with Botox to relax the muscle, otherwise the effect of the filler is very short lasting.
Consider another Botox practitioner
May I suggest that if you only had Botox once, you try another physician? Botox is an art as well as a science. You might really like the result when done by some other practitioner.
Botox is the treatment of choice for forehead wrinkles. Prior to Botox, we only had collagen injections for wrinkles and this did not work very well for forehead lines. Some lines do respond nicely to a hyaluronic acid or human collagen filler, but when these are done, it is often done along with Botox as well!
Resurfacing with any device is not expected to give you long term improvement because the muscle continues to move without the assistance of Botox, and the skin creases again from the “accordion” effect.
But you may have a special condition if you do have so many lines at the age of 29 and a consultation and second opinion with a specialist (dermatologic surgeon or plastic surgeon) is in order.
Get another opinion on the Botox
and be able to describe specifically what it was that you did not like about your first Botox treatment. There are many ways of injecting Botox to smooth forehead wrinkles. Another provider may be capable of smoothing the lines and avoiding the effect that you did not like. Good luck!
Juvederm is helpful for certain kinds of forehead wrinkles.
Your question is best answered if you are seen in consultation, but Juvederm can be useful for "static" wrinkles - ones that are present when the muscles are at rest. Juvederm works very nicely in combination with Botox for low forehead wrinkles between the eyes that are made worse with frowning, if they are present at rest.
Juvederm will not help with the appearance of the horizontal forehead wrinkles if they are not present at rest. Even if these wrinkles are present at rest, injection of Juvederm can be problematic, as migration of the material may occur, with a lumpy result.
An appropriate amount of Botox can be injected to the forehead without causing a "frozen' look. If repeated every 4 months or so, the static wrinkles of the forehead will gradually "iron out."
Give Botox another shot : )
I would ask you to reconsider Botox for your forehead wrinkles. I am assuming you didn't like how it looked because your forehead ended up being "too smooth" or "motionless". Or maybe the wrinkles didn't go away as much as you would have liked? Either way, trying Botox again for your concerns would be worthwhile.
The horizontal wrinkles on our forehead and vertical wrinkles between our eyebrows are caused by muscles which actively contract and pull on the skin - this is what causes wrinkles to appear. The Botox works by weakening these muscles and thereby softening the wrinkles.
By injecting a smaller but more concentrated amount of Botox, these same forehead wrinkles can be softened and improved without sacrificing a natural look to your forehead.
Fillers, like Juvederm, can be used for wrinkles that you see at rest (when the muscles are not moving). However these tend to be not as common in the forehead and unless the Juvederm is carefully injected you may end up with visible "lumps and bumps" when you do use your forehead muscles.
So I would recommend that you try Botox again but via a different concentration and technique - over and over again this has been shown to be the most successful way to improve forehead wrinkles.
Dr. Kamran Jafri