How do I fix it this horizontal forehead dent that could be Botox induced? (Photos)

The photo clearly shows a forehead ridge of bony prominence. What is likely is that the prior Botox injections, by shrinking the forehead frontalis muscle a bit, contributed to the greater prominence of the bony ridge below it. The use of a filler can help to smooth the transition between the prominent ridge and the remainder of the forehead above and make the transition more gradual. However, this area is an advanced injection site and not an area for novice and medspa injectors. Be very cautious about claims for this or that relatively expensive light or energy-based treatments since these are backed far more by device manufacturer supported marketing hype and little hard science.  You would be well advised to seek consultation and treatment by a board certified aesthetic physician. Best of luck to you. 

this "line" is your bone and if you want it improved you need fillers or fat injections. it always becomes more apparent with botox.A combination approach would give the most improvement. Movement lines and superficial wrinkles improve best with botox, dysport or xeomin.  Fine wrinkles need lasers like clear and brilliant, fraxel or erbium or co2; radiofrequency like venus viva or intensif microneedling RF; microneedling with PRP and stem cells; aquagold treatment; or soft fillers like belotero, restylane silk or refyne, revanesse versa, or juvederm volbella.  Deep wrinkles can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building.  Agressive deep peeling like phenol/TCA and J plasma can be used for deeper scarring or wrinkles.  Ultherapy is great for lifting of this are and thermage is great for tightening and improving overall texture.  Montly facialis like silk peel, dermalinfusion, salt facial, and microneedling with retinol masks can really help fine wrinkles and pore size. You really need a combinaation apporach and proper daily skin care and sun protection for the best results.  Please consult with an expert.  Best, Dr. Emer.

I appreciate you sharing your concerns.Loss of muscle bulk could account for this issue. Switching to Dysport or reducing the dose/frequency of your injections might help.I suggest you discuss this issues with your trusted injector.Best, Dr ALDO

Thank you for sharing your excellent question and photographs.  This may have occurred due to atrophy of your forehead muscle and can be improved upon with either dermal filler placement or fat grafting.  Hope this helps.

What i see in the photos it's natural shadow between your brows and forehead.  I don't think this is caused be Botox.  I assume you are having your frowner muscles between your eyebrows (glabella) injected?  Hypertrophy of the glabellar muscles could cause the shadow you've noticed.  Theoretically, Botox could help shrink these muscles and provide some improvement.  Otherwise, this is pretty subtle and i would try not to worry about it.  Don't get filler for this.  

Frankly I am not sure if many years of Botox injections could cause enough atrophy of the frontalis muscle to make the natural boney ridge appear more prominent, however, there are many fillers that can soften the transition and make it less noticeable. If you like the result of this then fat grafting may give you a better long term result.

I think you are referring to the bony ridge above your eyes which is part of your skull bone. It is likely that the botox has over the years reduced the fullness of the frontalis muscle which would normally conceal the ridge. I would suggest that if you withheld the botox for some time your muscle will recover enough to conceal the ridge again. Alternatives are to build up the junction so it is not as obvious with an HA filler, fat transfer or PRP.

The short answer is yes, the Botox did likely contribute to the natural ridge in your forehead to be more noticeable. The good news is you have a natural beauty that frankly, only allows you to notice. If you want to soften the ridge Platelet Rich Plasma (PRP) along with a small amount of filler will help. I would always start with one of the temporary fillers first (Juvederm is a good choice) before going to a long term filler such as Bellafill. Seek an experienced provider who understands the art of improvement in the forehead and the possible complications that can occur in placing fillers in the forehead area. PRP is very safe and can be used lone without the filler as an initial treatment for that area. Hope that helped!! 

Thank you for your question and for sharing your photographs CityPretty85. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.
It is difficult to make an assessment in the absence of consistent photographs before and after in the same lighting and angles for comparison. However, I hope the information provided here is useful.The appearance of frown lines is variable from person to person. Usually they are in a vertical orientation but sometimes they can be oblique and sometimes a horizontal line is seen across the upper portion of the nasal bridge. The most common variation is to have two parallel lines, hence the common term "11's" to describe them. But some people have one, three, or more lines. Some people also will see a bulge in the area when contracting the muscle. This bulge is smoothened out after a Botox treatment.The pivotal studies used 20 units of Botox in the glabella area between the brow to address the frown lines. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary. When patients present with concerns about specific wrinkles in the upper face such as the frown lines, I always assess and usually treat the other wrinkles in the upper face including the horizontal forehead wrinkles and crow’s feet. The reason is to maintain a harmonious and natural balance to the appearance of the upper face. The muscles in the glabella which are responsible for the formation of the frown lines serve to pull down on the inner brows when a person frowns. Similarly, the muscles around the eyes which are responsible for the formation of the crow’s feet seen when smiling (orbicularis oculi) are also responsible for pulling down on the brows, but in this case the outer brows. On the other hand, the muscle in the upper forehead which is responsible for the formation of the horizontal forehead wrinkles when a person raises the brows (frontalis) serves to pull the brows upward. If one of these muscles is relaxed with Botox and the others are not, the other muscles will still be active. This will lead to an unbalanced and unnatural appearance of the upper face where the brow can be elevated, depressed, or uneven in shape or position. Therefore, I recommend that my patients take a global approach to the upper face when receiving Botox treatments and treat all three of these areas. Sometimes bunny lines on the bridge of the nose are also treated.It is difficult to tell by the information provided here where exactly the Botox has been used. I suspect only the upper forehead has been treated without treating the glabella between the eyebrows. In this case this muscle can get larger and appear as a bulge. This can easily be corrected by placing Botox directly into the bulge.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!

To determine if this is caused by Botox, I would evaluate your photographs prior to the treatment and progressively since then. I believe that fat grafting to the area will round out your forehead and give you a natural and at the same time near permanent result. Good luck from New York City