I still have glabella lines after Botox. What is the fix?

Question

I still have glabella lines after Botox. There is plenty there – – I can't move a thing. They are less like wrinkles, and more like sagging maybe. What do you suggest for getting rid of them?

Yannis Alexandrides, MD, FACS · Answer

Botox
  should last from 3-6 months and takes around 2 weeks to fully kick in. When
  did you have your Botox? Typically, I see patients getting movement back
  around the 11 week mark. The duration and the results of Botox varies
  depending on the size of the forehead, strength of the muscle and the
  dosage. It may just be that you need a higher dosage. Consistency also plays
  a role as the muscle starts to adapt to the lack of movement and the muscle
  memory starts to remember not to create the expressions that causes the
  wrinkles. Therefore, if you're consistent with your treatments in the
  beginning, you may find that you'll need less treatments as you go
  on. If you have deep residual lines, you could also look into having hyaluronic acid filler in the area
  which could help fill out the irregularities and indentations to give a
  smoother appearance.An endoscopic brow lift could also be another option.

Kenneth Hughes, MD · Answer

How many units were injected? You may have very strong muscles in that area and require a bit more units, you can try using dysport as an alternative if Botox is not working for you.Kenneth Hughes MD

Timothy R. Miller, MD · Answer

Glabellar lines (the wrinkles between your eyebrows and often called the "11s") can persist after a successful Botox treatment if the wrinkles were very etched and deep.  Botox only "relaxes" and decreases the tone of the muscles creating the wrinkles; Botox does not fill the wrinkles.If wrinkles persist the options are to be patient and continue to do Botox on a regular basis (every 3-4 months) and overtime some patients will continue to develop smoothing in the area from the persistent effects of Botox.  Others may want quicker or more definitive smoothing and a filler such as Juvederm, Belotero, or Restylane can used.  Some may also need laser resurfacing  to the area.I hope this helps.

Jason Emer, MD · Answer

A combination approach would help give improvement with Botox and lasers, microneedling/prp and/or fillers. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Monika Soni, MD · Answer

Thank you for your question and sharing your photographs. Botox is used to relax facial muscles and help reduce wrinkles. However, it seems like you will benefit from the use of fillers. I recommend you see an expert injector to determine the best treatment plan for you. All the best!

Hardik Soni, MD · Answer

Thank you for your question and sharing your photographs. Botox is used to relax facial muscles and help reduce wrinkles. However, it seems like you will benefit from the use of fillers. I recommend you see an expert injector to determine the best treatment plan for you. All the best!

Andrei Metelitsa, MD, FRCPC, FAAD · Answer

If you still have visible lines after recently getting botox injections, you should book a follow-up with your treating physician. If appropriate, additional botox dose could be administered. However, in some instances getting more botox can increase the risk of droopy eyelids. Instead, injectable fillers (such as restylane or botox) can also be used in this area. Make sure that you see an expert injector especially if you're considering fillers in this area of the face.

Onir Spiegel, DDS, PhD · Answer

Botox will work if you space your injections about 3 months apart.  If you started injecting later in life after you've had strong lines already, the indentations will not disappear after the first series.   It takes time and I wouldn't give up after one session.   If you keep on top of it,  you'll see great results in time.   As the years go by you can space out the injections to 4 or 5 months.   Best wishes.

Jennifer Trent, MD, FAAD · Answer

Botox works primarily on dynamic lines, or the lines you have when you contract your muscles.  Over time it helps with static lines, or lines you have at rest.  Fillers are an option, but it can be a dangerous area to inject.  Always seek treatment from a qualified physician.

Benjamin J. Cousins, MD · Answer

Thank you for your question. Sometimes these lines still hand around even after botox/dysport. HA fillers may be useful here, but this a high risk area for filler injection. Be sure to see an experienced injector for your concerns.Sincerely,Benjamin J. Cousins MDBoard Certified Plastic Surgeon

I still have glabella lines after Botox. What is the fix?

Answers (20)

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