What would be the best (mosteffective/less invasive) tratment for a 24 year old with deep forehead expression wrinkles? (photo)

Working as a high fashion model expression lines are becoming a problem. I'm not very prone to undergoing cosmetic surgery since I'm happy with my overall appearance but this small, yet noticeable, defect has been affecting my job in the last months. They have become noticeably deeper with a more frequent sun exposure. What would be the best solution? I'm somewhat more open to laser resurfacing rather than botulyn injections but I trust a doctor's opinion more than my own. Any suggestions?

Doctor Answers 9

Expression Wrinkles

Botox would make a big improvement with your forehead lines. If used on a regular basis, the lines will soften and improve.

Princeton Facial Plastic Surgeon
5.0 out of 5 stars 26 reviews

Laser or Botox for Expression lines?

Great question. I would definitely advise Botox or Dysport treatments to control existing wrinkles and expression lines as well as to prevent any future lines. Laser resurfacing is not necessary for the time being, it will not control the expression lines but it will help overall skin texture and appearance. Consult with a board certified plastic surgeon you feel most comfortable with. Botox and Dysport treatments typically blast 3 - 4 months and you have nothing to worry about. Best of Luck to you.

Omar Fouda Neel, MD, FRCSC, FACS
Montreal Plastic Surgeon
5.0 out of 5 stars 22 reviews

Skin care and sun protection

Medical grade skin care and sun protection are the best first steps.
However, established wrinkles will need some treatment such as Botox.

Keith Denkler, MD
Marin Plastic Surgeon
5.0 out of 5 stars 18 reviews

Solution for 24 year old With Deep Forehead Wrinkles

You have a number of options. First and foremost, limit your sun exposure. UV rays destroy the elastic properties of your skin and contribute to wrinkles.

As for procedures, Botox will paralyze the muscles that are contributing to the horizontal lines. Even with Botox, the lines may not fully disappear if they've been there for a while or are deep. Repeated use of Botox can be preventative. Many in the entertainment industry, in particular actors/models will start using Botox in small does as a prophylactic measure so they don't get lines in the first place/slow onset of lines.

If you still want further improvement after Botox has lessened the appearance of your forehead lines, you may augment Botox treatment with a filler. All these methods are temporary, however. A forehead lift, provided there is enough laxity of the forehead skin, can remove/reduce these lines but comes at the cost of a scar in the scalp and downtime from surgery.

As for laser resurfacing, about 10 days social downtime - think beet red face. Botox, really no downtime unless you get bruising, which would be minor. Takes up to 10 days to get full effect from Botox.

Millicent Odunze-Geers, MD, MPH
Sacramento Physician
4.7 out of 5 stars 6 reviews

Too young for wrinkles?

As we age, more and more wrinkles become obvious. When thinking about treatments, it is best to think of it as a 3 step process. It is always a good idea to start out with a medical grade skin care line to prep the skin for any upcoming treatments or procedures. Surgery is usually the most effective way to get drastic results. However, you may not be ready to go that route. Once you have beautiful, tight, amazing skin, you must maintain it with additional treatments. This could range from anything as simple as a light chemical peel to more aggressive laser treatments. Maintenance is key to a good outcome. Consult with your Board Certified Plastic Surgeon to see which treatment plan is best for you and your particular needs.

Steven M. Gitt, MD, FACS (in memoriam)
Phoenix Plastic Surgeon
4.8 out of 5 stars 36 reviews

Botox for Expression Lines

In terms of the least invasive procedure botulinum toxin such as Botox or Dysport would be the best option for several results. First they will soften the lines and second they will prevent the lines from becoming deeper.  In terms of chemical or laser peel, an aggressive one would give you longer lasting effects however it would not do anything for the muscle activity so you would be prone to forming them again.  And then you would have to consider Botox. 

All the best

Dr Soni

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 44 reviews


In my opinion, Botox would be the best way to treat the wrinkles on your forehead.  By putting the muscles to rest, the Botox would serve to relax the wrinkles.  Also, Botox has a preventative effect!

Forehead lines, male model

For the least invasive but most effective regimen, I would first do a deep chemical peel such as TCA-25 in combination with Botox or Dysport injections.  The peel should be done by a medical professional experienced in TCA peels.  The recovery time from the peel is about 1 week.  By exfoliating the top layers of skin, the lines ideally become less prominent.  Botox/Dysport are both muscle relaxers that may be injected into the muscles of the forehead, decreasing the movements that produce the wrinkles.  Botox has no downtime.  It takes about 3-4 days to "kick in."  If the peel proves to be effective, as it should, then you may consider doing a 2nd peel 4 weeks later.  Be well-

Estee Williams, MD
New York Dermatologist
5.0 out of 5 stars 18 reviews

Botox For Forehead Expression Lines

Thank you for your question and for sharing your photograph.  Sorry that you are having some concerns about your expression lines.  Botox works well to soften expression lines around the eyes and on the forehead.  Botox treatment will soften the contractile ability of the underlying muscle and, as a result, improve the appearance of the overlying skin creases.  Please keep in mind that Botox will start working a couple of days after injection and the final result will be seen at 2 weeks.  Botox typically lasts for 3-6 months.  Etched creases may require multiple Botox treatments to see the best result.  Please be sure to see an experienced injector for an in-person consultation to fully address your concerns and discuss your goals and expectations in order to determine the best course of action.  Best wishes!

Christian N. Ford, MD
Cohasset Physician
5.0 out of 5 stars 30 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.