Will Botox help relax my forehead muscles to stop this dent? (Photo)

Question

Hi there I’m hoping you can help please? I currently have a dent in the middle of my forehead which I have had for years. I constantly frown which is almost like a twitch which I believe is making my eyebrows to feel raised which is causing the dent, would this be a possibility? I’m thinking of getting Botox to hopefully stop me from frowning and relax the muscles. Do you think this would work?

Luis Villar, MD, FACS · Answer

As a general rule dents and creases are are improved with fillers.  Creases and wrinkles caused by the contraction of muscles perpendicular to them in the brow, frown, and crows feet improve with Botox/Xeomin neurotoxins.  If a crease or dent that requires fillers occurs in the frown or forehead area, it is best to deactivate the muscles with neurotoxin and inject fillers a week after treatment when contractions have ceased.  This prevents the contractions from displacing the fillers in active muscle areas.

Ron Shelton, MD · Answer

In some situations, a dent appears but in reality it is not a depression. It is normal elevation of the forehead but it is surrounded by bulging muscles that create the appearance of a dent or valley between the mountain ridges.  Botox injected into the raised surrounding muscles can help flatten them and make the area seem flush again.It requires a physical exam to see how the skin and muscles work in relation to underlying contracture.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs. The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

Steven H. Williams, MD · Answer

Hello, thank you for your question. This concave indentation is likely due to the shape of the forehead bone and forehead muscle. I believe using both filler to fill this space and then botox to relax the muscles will give you the best result. However, this is a high risk area for filler so make sure to find an experienced provider who will complete a thorough consultation and assessment. Good luck!

Anthony P. Terrasse, MD · Answer

Thank you for your question. From your photo, it appears that you would benefit from both Botox and an injectable filler. The dent can be the result of several things - the shape of your skull, loss of volume, etc. - and is best addressed using fillers. Combining the filler with Botox will help relax the muscles and reduce your “twitch” of consistent frowning. My best advice would be to schedule a consultation with a board certified plastic surgeon who is a trained and experienced injector. He or she can examine you and offer options for the best combination of injectables to help you achieve the results you desire. Best of luck.

Rafael Gottenger, MD · Answer

Good Afternoon and thank you for your inquiry. Botox will definetly help you to relax the muscles on your forehead, in consecuence the dent will be less noticeable as you wont be able to frown. If there is loss of volume as well, then the combination with a dermal filler could give you a better result! Always look for a board certified physician.

Monika Soni, MD · Answer

Thank you for your question. This concave indentation is likely due to the shape of the forehead bone and forehead muscle. I believe using both filler to fill this space and then botox to relax the muscles will give you the best result. However, this is a high risk area for filler so make sure to find an experienced provider who will complete a thorough consultation and assessment. Best of luck!

John Tanqueray, MBBCh · Answer

Thanks for your question - from what I can tell from your photo it looks like you have some indentation over the centre of the forehead from the bony shape beneath, and maybe a little loss of subcutaneous fat here as you have got older.While some Botox may help to soften the area, if you are lacking volume here then a filler may be necessary to achieve the result you are looking for. If considering this make sure you see someone with appropriate expertise.Best wishes.

Mark Kearns, MBChB, BSc, FRACGP · Answer

Hey there, thanks for the question.
To me, the contour of your forehead looks like it's following the shape of your skull. This can be altered with fillers, but between the eyes in a very dangerous area to fill with regards to blindness. Maybe start with botox first and see if this makes any difference to the muscle shape over the skull over time.

Jacqueline Calkin, MD · Answer

Botox is the best place to start. Part of the contour irregularity may be due to hypertrophy of those frown muscles. Therefore, before you add filler, I would do Botox a couple of times (every three to four months). Once you’re no longer frowning all the time, the muscles will atrophy and flatten. This may well be enough.  Best to you.

Camille Cash, MD · Answer

You will probably find the best result from a combination of filler and Botox.  The filler can be used to disguise the contour differences and Botox can help relax the muscles.  See an experienced injector near you to learn more.

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