Vertical lines on Forehead - what caused this and what is the best procedure to address this concern? (photos)

Question

Hello, I am 49 years old, and in the last two years I have noticed my forehead go from unlined to developing numerous wrinkles as shown on the photo. Is this caused by fat loss? I have tried Botox but that does not seem to help with the dents. Please advise on the best procedure (forehead fat transfer/filler/botox) to address this concern.

Richard Chalmers, BSc (Hons), MSc, FRCS (Plast) · Answer

Hi, thanks for the question. I agree with the other surgeons that it is difficult to assess the issues from one photo alone. The general rule is that if they worsen as you try to scowl (ie muscle contraction) then Botox in the right place should help. If there is a degree of volume or contour loss then fillers including Hyaluronic acid products or fat injections could help. I would recommend a review with an experienced doctor to assess you face to face.Kind Regards

Mark T. Boschert, MD · Answer

It is hard to tell from the photo but it could be a combination of everything right at 49 years old. I would look at addressing the muscles with Botox, and skin resurfacing or micro needling treatment or something to help improve the quality of the skin to induce collagen formation. There are many energy devices and skin care products that can do this. It is most likely atrophy of skin that is giving you this fine vertical lines. Best of luck! Dr. Boschert Renaissance Plastic Surgery Saint Peters Missouri

Mats Hagstrom, MD (license on probation) · Answer

The lines certainly do look like frown lines related to tension or contraction of the corrugator supercilious muscle.

If Botox did not help though I’m guessing at least it doesn’t make it worse than the next step is probably using fillers.

I think it’s important to get a dynamic assessment including contraction of the corrugator muscle to see if this muscle contributes to the lines.

Best,

Mats Hagstrom MD

Vertical lines on Forehead - what caused this and what is the best procedure to address this concern? (photos)

Answers (3)

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