How do I fix these indents between my brows? (Photos)

Thank you for your question in regards to Botox. It appears that your glabella muscles are quite strong and would require a higher dose of Botox rather than just 20 units. To be sure what is best for you, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

This needs a combination approach with fillers, lasers and microneedling along with botox.  I suggest seeing an expert.  Best, Dr. Emer.

Deep glabellar lines? Your can try increasing the strength of the Botox. If that does not work the muscles can be cut as part of a brow lift done by a very experienced brow lift surgeon.

Thank you for your question. It will most likely be in your best interest to have a combination of Botox and fillers. Typically those muscles are large from use over time. Botox can help to weaken the muscle and make it smaller. The filler will help to smooth the lines or "indents". Hope this helps, 

Botox is indicated for lines that are caused by muscle activity. Lines and contour irregularity at rest are best addressed with injectable fillers and skin resurfacing, with surgery, or a combination of all of these measures.

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!

I would advise a higher dose of Botox, perhaps 30-36 units, and add a filler as well (filler should be strongly considered when indents/wrinkles are present at rest as in your case). Best to see your dermatologist for optimal results & safety.

Dear a.jones11: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,Dr.  Clark

It sounds like you are frustrated by the persistent fullness and indents despite treatment with Botox.  In order to answer your question completely there are several additional questions to ask.  First, while pictures are helpful, they are with just a snapshot, and when you are trying to evaluate how effective a Botox treatment is, watching which muscles are functioning is much more helpful.  This should be done by an experienced injector in order to understand why the treatment didn't have the desired outcome.  Assuming that you were injected appropriately with sufficient good quality Botox you have either had an incomplete response or no response.  If it is an incomplete response, regardless of how many units received, you can be treated with either more units or in a more effective fashion.  If you truly have no response, then you may be a non-responder, which occurs occasionally and it would be reasonable to try either Dysport or Xeomin to see if they are more effective,  There may be a role for fillers in the area but that would be an off-label use and carries with it some additional risks.  Furthermore, if the muscles are still contracting they will break down the filler and the benefit may be short lived.

I would consider injecting a filler into the indentation.  My preferred filler in this area is Belotero which is injected in small amounts superficially.  This is considered an advanced area for filler injections.  Make sure to see an experienced physician injector.Regards,Dr. Ort