Alternative to Botox for horizontal forehead creases? Can fillers work?

I tried Botox, and it was administered by someone with 10 years experience. I was cautious, so she only applied a single vial to the creases about 1/2 to 3/4 in above the brow. Within a couple days, the Botox had migrated down into the muscle in the brow, sagging it so significantly that it looked like I'd had a stroke. I'm 55 years old. I've had great luck with fillers everywhere else in my face. Can one of the thicker, longer-lasting fillers work for the horizontal forehead creases?

Doctor Answers 2

Alternative to botox in forehead

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In reading your narrative it is likely that too much was placed too low in the frontalis muscle in the forehead that resulted in your brow drop, not that the Botox migrated.  By placing Botox a little higher on the forehead you may acheive a good result without the drop.  Caution must always be used in placing filler in the forehead.  Small amounts can be placed selectively and carefully.  

Dr. ODell

Droopy after Botox

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The good news is that drooping from Botox fades over time and usually resolves in 2 to 3 months.

In general, Botox is a better treatment for forehead lines and wrinkles than filler.  While dermal fillers can be used in that area, the risks are significantly greater than with Botox.  When I treat a patient with filler in the forehead area, I normally do it very carefully using a small amount of diluted filler.   

I hope this is helpful and good luck.

Marlin Gill, MD
Decatur Family Physician

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