Radiesse Vs Restylane for Deep Frown Lines.

Question

The expression lines between my eyes have become severe over the years. Recently, I got a dose of Dysport, but that did not do anything for me. I am considering getting a filler such as Radiesse or Restylane. Which one would work better. Since Radiesse is a bit more costly, I wanted to know if it would be worth it over the Restylane?

Alan B. Brackup, MD, FACS · Answer

Let me preface this by saying I have no experience with Radiesse in the frown lines. I do however have extensive experience using Restylane in this area, especially in combination with Botox. The combination of these two can often be spectacular, and I have seen the Restylane last years when the patient has stayed commited to the use of Botox over time. I would not recommend any filler in this region unless it is combined with a neurotoxin such as Botox or Dysport, as its longevity will be severely limited.

Young R. Cho, MD, PhD · Answer

Thank you for your question. The frown lines between the brows can be address two different ways:
1) Botox or Dysport can be used to soften the deepening of the frown lines when making a frown expression. The treatment may even soften the lines that are present at rest.  The effects typically last 3-4 months depending on the dose.
2) Restylane or Juvederm can be used to soften the frown lines that are present even when you don't make an expression.  This can last for a year or more when used in conjuction with Botox.
For someone who has concerns with both the static lines (without expression) and the dynamic lines (with expression), then using both products would work well together. 
I often find that patients who return after a Botox or Dysport treatment in the frown areas complaining it didn't work, is due to the confusion between the static and dynamic frown lines. They continue to see the static lines even though the dynamic lines have softened considerably.

Sarmela Sunder, MD · Answer

Hi ELO,

	I have found that a combination of neurotoxin (Botox or Dysport) and hyaluronic acid (Restylane or Juvederm Ultra) work very well for vertical glabellar lines (&ldquo;the angry 11s&rdquo; or &ldquo;forehead frown lines&rdquo;). The results seem to last longer and look better when the two are used in combination.  I would recommend against using Radiesse in the mid-forehead area because of the risk of injecting material into the prominent vessels in this area. Since the hyaluronic acid products are thinner products they can be injected pretty superficially and avoid the vessels. Hope this helps!

	Dr.Sunder

Michael A. Persky, MD · Answer

HI ELO,

	The best treatment for glabellar lines (frown lines) is combining a filler (Restylane or Juvederm) with a neuromodulator (Botox, Dysport, or Xeomin).  Stay away from Radiesse injections in this area!

	Dysport does work, but perhaps your injector either misplaced the injections or did not use the proper dosage.

	When the glabellar line is filled and the muscles weakened simultaneously, there is a synergistic effect where the line often does not come back even when the Botox and filler would have worn off.

	Choose your injecting physician most carefully.  Good luck and be well.

	Dr. P

Lorrie Klein, MD · Answer

As there are many blood vessels between the eyebrows, many expert fillers such as myself avoid the use of thicker fillers in this area, to avoid occluding (blocking) any of these important vessels. Juvederm and Restylane are great choices and can often laser over a year in this area if Botox is concurrently done. Radiesse, Juvederm Plus and Perlane, on the other hand, I avoid in this area.

David Hansen, MD · Answer

Restylane or Radiesse both work great for frown lines between the eyebrows if you already have dysport/botox working.  Radiesse will last longer (1 yr) vs (6-9 months for restylane) and is worth the extra money. Both look natural though and you won't make a wrong choice with either one.  Sincerely,

	David Hansen,MD

Deborah Sarnoff, MD · Answer

Deep frown lines in the forehead occur because the corrugator muscle is very active. The best way to improve this problem is to put the muscle "at rest" by injecting Botox or Dysport. This will not only improve the lines but help to "retrain" you so that the muscle does not contract as much in the future. Sometimes a very small amount of filler is used "off-label" to further improve the cosmetic result. This is an area where great caution must be exercised -- be sure to seek out an experienced dermatologist or plastic surgeon.

David A. Bray, Sr., MD · Answer

Botox or Dysport are the champions of forehead lines. Although the fall back position is to use fillers. However fillers generally don't do well. If you want to try I recommend restylane because Radiesse is too heavy a filler for the forehead and might bump. Stick with your Dysport. Over time it should work if you are being given th e right dose in the right place.

Samir Shureih, MD · Answer

Deep frown Lines are best treated with Botox and a filler.

	Start with Retylane forst if you like the results will then consider Radiesse or fat transfer

Eugene Mandrea, MD (retired) · Answer

Botox or Dysport should be used first. You may not need any fillers if the frown lines are not  too deep

	Due to the presence of numerous blood vessels some of whom  can communicate with the retinal vessels, extreme caution is advised. I would use tiny amounts of Prevelle or Juvederm in conjunction with Botox or Dysport, following which, in the future, you may need only the Botox or Dysport.

	I would advise against Radiesse in that area.

Radiesse Vs Restylane for Deep Frown Lines.

Answers (13)

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