Concerned about my static frown lines: I recently had 14 units of Botox in my frown lines. (Photo)

Botox will help soften up the area over time, but it does not treat static lines instead dynamic lines. To put a small amount of filler there I would go to an expert personal such as a board certified plastic surgeon or a dermatologist as is it a high risk area

Hi mischerae, thank you for your question. It sounds like you’re on the right track. A well-trained aesthetic dermatologist will typically aim to reduce muscle movement without knocking it out totally. If you completely lost your ability to frown, you could look unnatural or “frozen."
Botox reduces your ability to make the expression that caused your static frown lines. Over time, ongoing Botox treatment will prevent the lines from getting deeper, and may eventually cause them to soften. It is possible to place filler in their area, but it is a higher risk injection site.
If you have not already, I recommend seeking out a board certified dermatologist who specializes in injectable treatment. After an in-person assessment, they can help you understand the benefits you might expect from regular Botox treatment, and weigh the risks and rewards of filler. Additionally, I recommend discussing a skin care regimen that will help you reach your goals. Regular use of medical grade skincare products, such as Retin A or a growth-factor serum, will also help to reduce your static lines. Laser resurfacing can also help to remodel the skin and reduce the appearance of fine and “etched-in” lines. Consider laser resurfacing after Botox to promote collagen remodeling.

Thank you for sharing your question and photograph.  It does appear that you would benefit from both additional Botox - to prevent worsening of the static wrinkles - and filler to help even the skin surface.  Take the filler in stages and you should see noticeable improvement.  Hope this helps.

First let me compliment your injector for achieving significant improvement in your dynamic glabellar wrinkles, but not leaving you incapable of motion. Back in the early 1990s, when I first started using Botox for aesthetic purposes, we mistakenly thought that it was necessary to "freeze" muscles. It took us some time to learn that this frozen, porcelainized look and inability to emote was artificial and did not contribute to a natural look. Think about it. If you look at a five year old child, you will see a nice, smooth, wrinkle-free area between the brows. But, just refuse to give that child ice cream and watch how deep a frown that child is capable of making. So, contrary to outdated conventional wisdom, the intent of treatment with neuromodulators (such as Botox, Dysport, and Xeomin) nowadays is to diminish  dynamic (motion-related) wrinkling, not to eliminate it entirely.  In your case, the residual static (lines at rest) eleven line creases (etch-in lines) present have resulted from years of folding the skin with facial expression, which lead to a situation akin to the creating a permanent crease from repetitively folding a piece of paper. Fillers can be helpful for these residual, static lines,. My preference is Belotero Balance in my NY office and for Teosyal Redensity II or Alaxian FL in my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available. Make sure you are seeing a board certified aesthetic physician. 

Deeper lines can be improved with a combination of Botox with fillers, lasers and microneedling/prp. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Botox prevents the muscles from contracting and causing wrinkles. It doesn't make the wrinkles go away that are already there and are mature. Filler or resurfacing is best for these depending on where and the characteristics of the wrinkle. 
Hope ya'll are staying safe down there in Florida- These storms will give all of us wrinkles! 
Hope this helps and God Bless!
Dr. Robb

If you had preexisting static lines, it is best to use optimal Botox correction approx. 30 units (at a 1:1 ratio) in the frown (glabella complex), and reassess at 14 days. Ensure the movement is fully relaxed before considering further treatment. If deep creases are still present after adequate Botox correction, possibly a soft dermal filler can be injected in the static lines. This is an area that should only be treated by an experience injector to avoid the facial vessels. Laser resurfacing is also a great option to smooth out lines/ wrinkles.  Dr. Solomon

Botox helps most with dynamic / movement lines but also improves static lines to some degree. If you have received an adequate dose of Botox and have waited for its full effect than adding more Botox is unlikely to improve the area.  Depending upon the location of your lines filler may also be an option.  Additionally do not forget to optimize your skin care regimen to minimize fine lines and wrinkles. Not everyone is a good candidate for this treatment so please see a Board Certified or Board Eligible Plastic Surgeon to evaluate if you may benefit. Good luck!

This content is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare professional.  You should always seek the advice of your physician or healthcare professional for any questions you have about your own medical condition. 

Thank you mischerae for your question.
In my practice, I advise my patients with this issue that we should give Botox several treatments to help improve this area. I am usually reluctant to use fillers for this area when I first see a patient as there have been several case studies of significant complications. My preference is to do at least 3 treatments of Botox and if there is not significant improvement, I would consider fillers as an option. It is imperative to go to someone reputable and properly trained in using fillers as the complications can be significant
Hope this helps and good luck.

Sta. tic lines are hard to correct with Botox alone. However, after serial treatments with Botox over 9-12 months, you should see significant improvement. For more rapid improvement, carefully placed filler by a very experienced injector can be done safely in this area. There are vascular occlusion risks which need to be considered. The injections need to be very superficial and an HA filler such as Belotero, Silk, or Refyne should be used.