Why are my frown lines deeper when I wake up?

I am 29 years old. I tend to frown a lot so I decided to start Botox. I started w/ 15 units. Def made a difference but I still noticed frown lines. I saw my Doctor & told her about the issue & went to 20 units. I still need more! Also, when I first wake up in the morning, the frown line creases are so intense! How am I frowning so much in my sleep? They are very deep in the morning. Not very narrow, they lean a little toward the left. Should I switch Doctors or increases to 30units?

Doctor Answers 5


Thanks for your question. Botox is a temporary neuroparalytic that is used to eliminate wrinkles in the periorbital and forehead area. Its also works well for softening the 11s (corrugated muscle). Fillers are used to add volume to the face and also deal with dipper folds and lines such as the smile lines and marionette lines. In addition filler can be used for filling the tear trough deformity and adding volume to the cheeks and lips. Please consult with your plastic surgeon to review the best options available for you.
Good Luck.

New Orleans Plastic Surgeon
4.9 out of 5 stars 28 reviews

Facial lines

Perhaps it is the way your are sleeping that may make the lines look a bit more prominent in the morning.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews


Hello and thank you for your question. Frown lines may be worse in the morning, this is true.  I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 131 reviews

Frown lines worse in the morning

All facial lines are often worse in the morning after sleeping on your side or stomach since the skin is folded up with pressure against the pillow and the lines get deep. Sleeping on the back is much better for lines but hard to learn if you didnt grow up sleeping that way. 

Rebecca Baxt, MD
Paramus Dermatologic Surgeon
4.8 out of 5 stars 27 reviews

Botox and Crease

It's possible that you are sleeping on your face and the swelling makes your wrinkles look worse in the morning.  Please consult an expert.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 78 reviews

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.