Juvederm or Voluma for forehead wrinkles? (photos)

Question

I am 51 years old with fairly deep horizontal forehead wrinkles. I used Botox for years and more recently Xeomin, but I have developed complete immunity to both. I get no appreciable response now. Would fillers be helpful, or is a brow lift my only option at this point?

Jerome Edelstein, MD · Answer

Juvederm Ultra/Ultra Plus would work well here, as Voluma is designed for areas that require substantial volume correction, such as the temporal areas and cheeks. As an alternative to Botox and Xeomin, you may want to consider Dysport.

Martin Jugenburg, MD · Answer

Fillers can be used to smooth out forehead lines, i would recommend a thinner filler like restylane as Voluma is very thick and is used for deep tissue areas like the cheeks.  I would suggest that you seek an experienced injector to discuss your optiions.  Best of luck

Michael A. Zadeh, MD, FACS · Answer

Hi June. It may not be that you are resistant to Botox, but sometimes deep lines and wrinkles cannot be completely erased with Botox. In these situations some filler can be used to help reduce the appearance of the lines even further. In these situations I prefer to use Juvederm or Belotero to accomplish this. Please find an experienced injector. Best of luck to you.

Brian S. Biesman, MD · Answer

Fillers can be used to help treat horizontal forehead lines.  There are a couple of ways in which this can be accomplished.  Sometimes a combination of techniques provides best outcomes.  Depending on your forehead anatomy, there are times when injection of fillers just in front of the bone can help smooth lines on the surface.  Deep etched lines are best treated by injecting product directly into the lines.  Again, sometimes a combination of both of these techniques provides the best outcomes.  I recommended seeing a highly experienced injector who is familiar with the most advanced approaches to injection.

Ariel Ostad, MD · Answer

Thank you for your
question. Restylane is a great cosmetic filler to plump up the skin and smooth
away forehead wrinkles. Another filler Belotero, also reduces the depth of
wrinkles, lines, and folds. The results are excellent, where the skin still remains
mobile and flexible giving you a natural look to show movements, to show
movements and facial expressions. Best Dr, Ostad.

Lois Wagstrom, MD · Answer

The horizontal lines of the forehead are caused by motion so you would need to stop the motion or any additional treatment would not be of benefit.  You might try Dysport as a 3rd option to try to stop the movement however normally if used in appropriate amounts Botox should do that as well.  A browlift would help definitely if it is an option for you. If you opt for the non surgical approach and can get some improvement on your motion then you could try laser resurfacing to help smooth out the remaining wrinkles.  Fillers are not best for this type of wrinkle; however, if you wanted to try a filler it might be best to use something thin that could be placed superficially like Beletero.

Suzanne Kilmer, MD · Answer

Its very rare to have immunity to  Botox
and Xeomin – and I have treated thousands of patients and do have one patient
that really doesn’t respond much to either. You can try Dysport as it is
different botulinum toxin  and also try different injection techniques,
amounts and placement. Fillers are helpful for filling the lines but don’t stop
the muscles from making the lines. I would stick to a thinner filler like
Juvederm or Restylane Silk for the forehead lines and save Voluma for areas that
tolerate a more robust filler.

Martie Gidon, MD, FRCPC, FAAD · Answer

Botox or Xeomin stops movement and filler plumps up lines so both are often used for best results.  Voluma is a very dense filler used for areas such as the cheeks to give more volume so would not be appropriate for forehead lines. Restylane or Belotero would be a better choice, but treatment with an experienced physician injector is most important.

Juvederm or Voluma for forehead wrinkles? (photos)

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