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