How do I fix these indents between my brows? (Photos)
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Doctor Answers 20
Amount of Botox needed between the brows can be more than 20 units
Thank you for your question a.jones. Botox is a purified protein used to address wrinkles associated with facial expression such as the frown lines between the brows. The pivotal studies demonstrated that most people enjoy the results of a Botox treatment between the brows for 3-4 months when 20 units are used. In my experience this is the case for the majority of patients. Some people, however have stronger muscles and higher doses may be needed, sometimes up to 40-50 units. Alternatives for those who do not see results with Botox include Dysport and Xeomin. Please follow up with your doctor for specific recommendations. Good luck!
Treating indents / 11s between the eyes
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11 Lines on Forehead -- Botox, Filler, Lasers/Microneedling
Deep frown lines still present after Botox
This is one of those situations where you can be advised much more intelligently via an in-person consultation. There are two possible explanations:
1. You had no muscle relaxation whatsoever from Botox, in which case you should consult a board-certified advanced injector, a dermatologist or plastic surgeon, who performs these procedures daily.
2. You have developed these deep furrows from years of contracting your brows strongly, and relaxing them will not smooth them over unless you keep up the injections every four months (or just before the effect wears off) so that the muscles have an opportunity to become smaller over time. (Think of what happens when you cast a broken arm--because the muscles have not been contracting, they are smaller when you remove the cast.) If this is the case, which I think is more likely, you can have a filler carefully injected in the folds to smooth them over in the meantime. You can also consider having Ultherapy to the skin above the brows, which will help to tighten and lift the skin permanently.
It may be hard for you to tell which explanation is correct. Try frowning as hard as you can. Are your frown lines less deep when you do that than they were before the treatment? In that case, the second explanation is more likely.
All the best,
Belotero for indent between brows
A small number of patients are Botox "non-responders". In those patients where botox fails and patients also don't respond to Xeomin or Dysport (other types of neurotoxins), soft tissue fillers can be used in this area above the nose called the glabella. These can be very effective, but this area is know to have a higher incidence of vascualar complications compaired with most of the rest of the face so a very experienced injector is a must.
I will often do a procedure called a "glabellar myectomy" either at the same time as a brow lift, face lift, or simply as a stand alone procedure. This involves surgically weakening the muscles in this area with or without a combination of some filler or implant. This will generally smooth out that area nicely with a relatively simple procedure and be long lasting. Laser resurfacing can also be added to smooth the skin out. Often this combination of approaches is the best, most economical approach in the long run to get the most improvement you can.
Roger Dailey, MD, FACS