Can You Have Juvederm Injected Between the Eyebrows and Above the Eye Brown?

Question

I have used botox and disport for deep wrinkles between my eye brows and right above my eye brow. However, these don't seem to do anything to improve the wrinkles. It has been recommended that I now use juvederm. However, I had a nurse friend of mine tell me to never, ever use juvederm in this area of the face. I'm confused as what I should do. Please advise.

Kenneth Hughes, MD · Answer

If you continue to have a neurotoxin like Botox or Dysport, these lines should continue to soften over the course of a few years. If during that time you want more of a softening, you could use a filler. This area is a sensitive area for filler and would recommend only using a highly skilled Physician to perform the procedure. Best of luck.

Paul S. Nassif, MD · Answer

For the glabella, Botox or Dysport yield the best result. It is generally dangerous using filler in this area, and there are more risks associated. I would recommend seeking the advice of a board certified plastic surgeon, facial plastic surgeon, or dermatologist. They are all great choices. I hope this helps, and I wish you the best of luck.

Sanjay Grover, MD, FACS · Answer

Botox, Dysport or Xeomin are effective in relaxing the muscles that create dynamic lines or unwanted expressions. When one injects into the corrugator muscles in the 'frown' area, these lines or expressions will be improved. However, if one has been making these expressions for years, those lines will now be 'etched' in place. In this situation, I may frequently include a filler such as Juvederm in conjunction with botox to improve the appearance. I usually will wait one week after the botox injection to see if botox was sufficient alone. These injections of fillers in this area must be made with great care and while withdrawing the needle so that the filler is not mistakenly injected into one of the arteries in this area and potentially cause skin loss or blindness.

Asif Pirani, MD, FRCS(C) · Answer

You can have these products injected in these areas BUT there are more risks.  The worry is that the filler could cause an injury to the blood vessels in these areas and cause tissue necrosis, or even blindness if the filler tracked back through the vessels.  

	These areas usually respond quite well to Botox.  If your wrinkles aren't improving with these techniques, you should see a board certified plastic surgeon in your area to consider other options such as a brow lift.

	Best,

Sam Naficy, MD, FACS · Answer

HA fillers such a Juvederm, Restylane or Belotero can be used to correct the deep creases but the issue is a safety concern about injecting or compressing blood vessels in those areas. There have been serious adverse events and injuries reported. So it is imperative you see someone very experienced and knowledgeable about injecting that area. I prefer to use a blunt cannula method and inject a very soft product in those areas. We have had very good results with this method so it can be done safely if you know what you are doing.

Nelson Lee Novick, MD · Answer

Long-standing wrinkles are typically of two types: dynamic wrinkles, i.e. those that appear with movement of the muscles of facial expression, and static wrinkles--those that persists as etched creases in the skin after years of laughing, smiling, scowling, etc. 

	Neuromodulators, such as Botox, Dysport, and Xeomin work on diminishing expression muscle overactivity, in other words, they improve dynamic wrinkles. They do nothing whatever to erase or improve wrinkles, fine lines and crinkles that have already permanently creased the skin. To improve these, fillers may be used.

	Special care must be taken when the area between the eyebrows is treated, since there is a risk that some of the filler may enter blood vessels, travel to the small vessels eyes and lead to blindness. Likewise, too heavy a filler may compress vessels in the region and lead to skin necrosis and breakdown and permanent, disfiguring scarring.

	For this reason, I prefer to use dilute concentrations of Restylane and Belotero Balance in this region, the latter having the additional benefit of not causing the Tyndall effect--a bluish discoloration that sometimes results when hyaluronic acid fillers are injected very superficially or are injected into very thin skin.  For the forehead worry lines and crow's feet, full concentrations may be used. I do not use Juvderm when I am looking to lift a very fine line, since it has more of a tendency to attract tissue water to itself and hence is less predictable in staying within the borders of the fine line.  

	Prolonged improvements of up to one year are often seen when combination therapy is used, as opposed to only four to six months when neuromodulators are used alone. A board certified aesthetic physician, either a dermatologist or plastic surgeon, should be consulted especially for treating the scowl (frown) lines between the eyes for the reasons mentioned above

Hayley Brown, MD, FACS · Answer

Juvederm, or any hyaluronic acid filler for that matter, is not FDA approved for frown or forehead lines. Marketed fillers are only FDA approved for nasolabial folds and smile lines. However, you see many practitioners using products in various parts of the face with excellent results. "Off-label" means these products are used in these areas, with the understanding that the surgeon upholds the responsibility that his or her expertise can provide the treatment safely and effectively. Treatment in the central forehead needs to be done conservatively and with precision; your surgeon having a thorough knowledge of the anatomy in the area, in addition to vast experience. Critical blood vessels in the area must be avoided to avoid embolus (product in the vessel), or skin loss from vessel occlusion. You should see only an experienced Board Certified Plastic Surgeon for consideration of treatment in this area, and both of you should have a mutually trusting relationship so you can be confident in both your safety and outcome. Deep static lines in this area that do not respond to Botox do very well with the addition of filler in these situations. Belotero is also a great hyaluronic acid filler for this area as it is less perceptible and can be injected quite superficially.

William P. Mack, MD · Answer

Your wrinkles between your brows and above are cause by facial expressions
and contraction of those muscles in the area. 
In my practice, I do not use fillers in this area and instead use Botox
to soften the wrinkles between the brows as well as crows feet by relaxing the
muscles that are creating the wrinkles. Facial fillers are typically
administered in the middle and lower regions of the face to fill areas where
volume has diminished.

Benjamin Barankin, MD, FRCPC · Answer

If a person has wrinkles in the frown area only with movement, then Botox is usually sufficient. If there are wrinkles at rest between the brows, then Botox plus the addition of a filler such as Juvederm or Restylane is the optimal treatment. One must be careful using filler in this area because of the anatomy of the arterial supply, but this is rarely an issue in highly trained specialist hands such as that of a dermatologist or plastic surgeon. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Naveen Somia, MBBS, PhD, FRACS · Answer

Hi

	Juvederm can be very effective in filling the volume deficits between the eyebrows that make your wrinkles prominent and Botox less effective. You need to find a Doctor who is comfortable with using Juvederm in the area.

Can You Have Juvederm Injected Between the Eyebrows and Above the Eye Brown?

Answers (14)

More Juvederm Questions

WE SEND PRETTY
EMAILS

Answers (14)

More Juvederm Questions

3 days after Juvederm in the upper lip two large lumps formed and were drained. 2 weeks later Juvederm was gone. Thoughts?

Juvedurm in Tear Troughs Caused Permanent Bruise/dark Circle Under One Eye? (photo)

Possible Bad Reaction to Numbing Cream After Topical Application for Juvederm Injections? (photo)

Are Bumps in Lips from Juvaderm Permanent?

I Have Had Shingles in the Right Side of my Face Badly Once and Take Valtrex Tablets when I Feel It Coming On?

How Long After Juvederm and Botox Can I Use Retin-A Micro?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS