Do New Wrinkles Require Dermal Fillers or Just Botox?

I am in my mid-30s and have just noticed some new wrinkles on my forehead as I tend to raise my eyebrows a lot. If they are new, slight wrinkles and not deep do you think I will need a filler or should Botox be enough?

Doctor Answers 27

Forehead wrinkles and Botox: Recommendations for treatment

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Transverse (Horizontal) forehead wrinkles are treated with Botox injection with excellent results. Botox is a superior product for erasing transverse lines on the forehead. The clinical efficacy of Botox is far superior to fillers in this area

My recommendation would be to undergo Botox first and then determine if you need additional treatment with more Botox or fillers.

Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

If gentle manipulation erases the offending wrinkle, Botox is your treatment

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One quick trick to try is identify if you can delicate smooth out the wrinkles completely between your fingers. If gentle pressure is all it takes Botox will provide complete correction. Those individuals with deeper lines that cannot be gently cooerced into receding typically benefit from both Botox and filler. Based on your description at this early stage you will likely find that a lovely response is obtained with Botox only.

Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon
4.6 out of 5 stars 23 reviews

If they are not there at rest, Botox is all you need

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When you have totally relaxed the muscles, if the wrinkles are absent then Botox is all you need. After years of practicing making the wrinkles, the skin folds preferentially like an accordion. In these people, even when the muscles are relaxed, there are still lines on the face. These people also need a dermal filler.

Botox will work for you

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Based on your age and description of the culprit wrinkles, Botox should provide you with very satisfying results. It is very important that the injections are at least one centimeter above your brow line so that you maintain natural brow movement and expression while improving the forehead wrinkles.

Botox is indeed known to be preventative, however in my opinion this occurs more frequently with the crow's feet wrinkles (side of the eyes) and glabellar area (between the eyebrows). The frontalis muscle (which causes horizontal forehead wrinkles) is in most cases a thick muscle or very strong muscle due to its dense interactions with surrounding cranial and temporal fascial layers. Therefore the preventative benefit may not be as great in this area.

Good luck and good Botox to you!

Kamran Jafri, MD
New York Facial Plastic Surgeon

Botox for lines of Movement

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We all get wrinkles for various reasons. The ones that tend to dramatically worsen over time are usually caused by muscle movements and these are amenable to Botox. Botox softens the muscle contractions and shifts the stress from muscle movement to other areas preventing the constant wrinkling in the same spots.

Botox can be used on the forehead lines, the frown lines between the eyes, the wrinkle lines on the nose, around the lips if done carefully, around the eyes for crow's feet. Some lines that also bother people and are caused by muscle movement are the semi-circular lines out on the cheeks that become more obvious when we smile. These fine to medium lines can not be controlled with Botox without causing a droopy face. These lines are best treated by laser resurfacing, either fractional, plasma or CO2 lasers.

Edgar Franklin Fincher, MD, PhD
Beverly Hills Dermatologic Surgeon

Botox best for forehead expression lines

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The lines in your forehead are a result of the forehead muscles contracting and thereby wrinkling the skin. Botox (or Dysport) is the first line of defense against these sort of "active" wrinkle lines. The only time I use filler for these types of lines/wrinkles is when even after Botox, the lines are so etched in, that a filler can serve as the finishing touches in smoothing out the etched in lines and wrinkles.


Hope this helps!

Dr. Y

Haresh Yalamanchili, MD
Houston Facial Plastic Surgeon
4.9 out of 5 stars 31 reviews

Botulinum is best!

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Dynamic wrinkles in the forehead are best treated with botulinum injections (Botox or Dysport) and you are the perfect age for obtaining wonderful benefits from this treatment.  Just about 6 injections with a tiny needle will smooth your forehead and relax those lines that concern you.  Talk with either your plastic surgeon or dermatologist about this and you'll soon find how safe, effective, and ideal this treatment is.  Enjoy! 

Randolph Capone, MD, FACS
Baltimore Facial Plastic Surgeon
4.7 out of 5 stars 51 reviews

Botox only For New Wrinkles

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It sounds like you are the perfect patient to start Botox!  If you are young and only see the wrinkles with dynamic movement, you are the best canidate Botox for wrinkle prevention.  If the wrinkles are there at rest, then Botox will help soften them by preventing the muscle from further contraction, but you do need a filler to fill out the crease.  Botox as wrinkle prevention for forehead lines, frown lines, and crows feet along with sunscreen is a fantastic starting point for young patients!

Grace Liu, MD
Newport Beach Dermatologic Surgeon
4.9 out of 5 stars 52 reviews

Botox should be enough to prevent new wrinkles from deepening.

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If forehead lines are new and caused by facial expressions, Botox alone should be enough to soften the activity of the muscles and allow the lines to reverse. If they are long standing, deep folds, a filler at the same time can be synergistically helpful to smooth sooner and hold longer.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

Botox for forehead wrinkles

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Botox or Dysport is what you need for forehead wrinkles. Botox helps the muscles relax in the forehead and the lines will diminish. Botox or Dysport lasts 3 to 4 months. If Botox doesn't help with wrinkles in forehead than that's when a filler will help. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.