Filler between brows (Photo)

Question

I have used Botox for some years in glabella. I have always had a triangular hollow between brows. The past 5 years I have had filler there with success. Lately the filler won’t stay in place, acreating ridges on both sides while the hollowness remains. What can I do to have a flat area? I have tried massaging the filler and it helps for 10 mins. It seems like it’s never enough, going 3-4 times a year while previously once every year and it looked good. What can I do?

Anna Chacon, MD, FAAD · Answer

I understand your concerns and the discomfort you're experiencing with the changes in your filler results. There are several possible approaches you may consider:

1. Change the filler: There are many types of dermal fillers on the market, each with its unique properties and benefits. It's possible that your body is no longer responding well to the current filler you're using. A different filler might provide better results.

2. Consider other treatments: If fillers are not providing the desired results, other treatments may be considered. For example, fat grafting uses your own body fat to fill in the hollow areas. This could provide a more permanent solution, but it is a more invasive procedure.

3. Seek a second opinion: There may be underlying causes for the changes you're experiencing, and it could be beneficial to seek a second opinion from another specialist. They may have different insights or treatment suggestions.

4. Consult with a plastic surgeon: If non-surgical treatments are not effective, you may want to consult with a plastic surgeon to discuss surgical options.

Remember, it's crucial to discuss these options with your physician or a board-certified dermatologist or plastic surgeon before making any decisions. It's important to consider the benefits and risks associated with each option, and to choose the one that best suits your needs and expectations.

Eric M. Joseph, MD · Answer

When patients ask us for fillers in the area in between the eyebrows, we only do this very conservatively or not at all since visible products can occur. Since you have been using a temporary filler, you may wish to consult with your doctor about having those ridges dissolved. Moving forward, I would suggest only utilizing a neurotoxin like Botox in that area. Wishing you well. Sincerely, Dr. Joseph

Nelson Lee Novick, MD · Answer

Combining Botox to quiet the dynamic folding with HA filler for the residual static indentation typically prolongs the results greater than would be obtained from either treatment used alone. You would be wise to consult with a board certified cosmetic dermatologist filler expert. Best of luck.

Camille Cash, MD · Answer

Forehead filler is generally not recommended due to the risk of complications such as vascular occlusion.  You may look into skin treatments such as Morpheus8 which can improve skin tone and texture.  I've included a video I hope you find helpful.

Anna Avaliani, MD · Answer

Glabella is highly mobile area. It is also one of the most dangerous areas of the face to get injections.You should have gotten botox only to maintain the results of the filler . Botox prevents the movement of the muscles and will also help to keep the filler in place. It will also allow the filler to remain longer. In my practice of 9 years, if and when I do glabella filler, it's a one time treatment only. never recurrent like you have been describing. 
You may also discuss and try RF microneedling to tighten the skin and reduce pores size and potentially the depth of the wrinkles.
Always try to discuss options with your treating doctor.

Filler between brows (Photo)

Answers (5)

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