Aside from glabella/elevens filler, how can I get rid of permanent brow furrows? (Photos)

Question

I have permanent furrows between my brows--Botox really doesn't help as it seems that there's simply too much lax skin between my brows. It's like my face caved in a bit between the eyes, if that makes sense. What are my options to fix? I've wondered about temple filler--when I pull back my temple skin, the furrows smooth out and widen my eyes. What about laser skin tightening? RF between my brows?

Jason Emer, MD · Answer

Thank you for your question!  I would check and make sure that an appropriate amount of Botox was used. For glabellar lines (or frown lines / "11" lines), we inject Botox into the muscle, causing the muscle to weaken and improving the appearance of the lines. Botox works by binding to receptors that send nerve signals for muscles to contract.  Since your body makes new receptors and neurotransmitters all the time, it needs to be maintained otherwise the wrinkles will slowly return as the muscle regains function over time. Botox takes 2 to 4 weeks to start working and lasts for up to 6 months.
For deeper glabella lines or strong 11s, I use a combination of Botox with fillers, lasers and microneedling with PRP. I suggest getting a formal evaluation with an experienced cosmetic dermatologist and expert in lasers and fillers. Best, Dr. Emer

Camille Cash, MD · Answer

You will want to begin by ensuring that the dose you are receiving for Botox is correct.  If you are still able to furrow your brow after Botox is in full effect then more product may be indicated.  You can also consider FaceTite for the brow area to help improve and lift the skin in this area.  This is a nonsurgical procedure that is done in the office setting.

Steven Wallach, MD · Answer

Brow furrows can be softened with botox. If you do not want to do that and want something more permanent, then an endoscopic or open corrugator removal is an option.  Best of luck.

Julie Shelley, DO · Answer

Hello, and thank you for your question and photos! The first step would be to ensure you are having an adequate amount of Botox between the brows to completely relax the muscles that cause the brow to furrow. If you are being treated appropriately and are still seeing lines between the brows, I would recommend a combination treatment with radiofrequency laser skin tightening and microneedling with PRP. These treatments will be stimulate collagen in the area and help soften lines and wrinkles. As always, ensure you are using physician-grade skincare to help plump the skin to decrease the appearance of fine lines and wrinkles. I hope this helps!
- Dr. Julie Shelley

Bethany J. King, MD · Answer

Hello! Without any question, your 11 lines and the appearance of your eye unit would both greatly be improved with a brow lift. I would then continue to use a neuromodulator on your glabella to keep your 11 lines from progressing. Best of luck!

Robert T. Buchanan, MD (retired) · Answer

If the "furrows" in the glabella area are still present after Botox, but you are unable to actually contract the muscles, then the only treatment is injection of them with a filler to flatten them. You should also be using tretinoin and Obagi ELASTIderm to stimulate the body to use some of the hyaluronic acid from the filler to make collagen and elastic tissue to permanently eliminate the furrow. If you still have muscle function after Botox, then you need to see another injector who can eliminate the muscle function. (Because of the other sun damage you have, I would suggest using the entire Obagi Nu-Derm system that includes tretinoin and ELASTIderm.) A more permanent way of eliminating the muscle function is resection of the muscle, either as a stand alone procedure or as part of a brow lift. However, if the furrows are still present after proper Botox administration, you will still need the filler after muscle resection.

Aside from glabella/elevens filler, how can I get rid of permanent brow furrows? (Photos)

Answers (6)

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