Is There Any Help to Remove a Deep Furrow in Forehead

Botox is an extremely effective and easy way to manage forehead wrinkles, including deep furrows. This neuromodulator relaxes the dynamic muscles that cause wrinkles, allowing the overlying skin to smooth out. Depending on how deep your furrow is, you may benefit from a hyaluronic-acid based filler such as Juvederm, too. I hope this helps.

Your furrow may respond to treatment with botox if it is a muscle movement-related crease. If however it is caused by sagging thick skin and sun damage, then it may not respond.  Fillers may be needed as well as, or instead of, Botox.  An examination may provide useful information to help determine what the best approach is for you.

First get an in person consultation with your board-certified aesthetic physician regarding deep lines on the forehead, such as the 11's between eyebrows. I would consider Botox or Dysport first to minimize dynamic lines, i.e. those caused by involuntary muscle contraction. If there are still noticeable lines at rest, then these static lines, which are valleys between bands of muscles, can be filled in with hyaluronic acid filler such as Juvederm or Restylane which can be reversed if needed. Keep in mind that filler injection in glabella is an off-labelled indication and make sure that your aesthetic physician is prepared for contingency such as rarely occurred compromised localized circulation which requires prompt action.

Hi Jeani.  Most often, the term furrow is used to describe the "11" lines in the glabella area, the space above the nose and between the eyes.  For this area and these vertical lines, Botox or Dysport is probably your best and first treatment.

In some cases, we find that with deep furrow lines in this area, they may require a little dermal filler as well and we like Restylane.  The Botox or Dysport relaxes the muscles causing the line, but when it remains after Botox or Dysport has been injected, then the lines are too deep for just this one treatment and that is when Restylane comes in.  

Check out the eighth set of pictures at the link below to see a patient with a very deep furrow that had Botox and Restylane.

     Initial evaluation should determine whether this is a static or a dynamic cause. The severity of the furrow should be assessed.  Most commonly these represent themselves as "# 11" between the eyes and they are usually vertically or slightly obliquely oriented. Sometimes you could have a horizontal furrow as well. Some individuals may have a single, very deep furrow. Initial therapy usually includes a trial of botulinum toxin  with or without a filler. Caution must be exercised when injecting any filler in this area as it is prone to skin slough or necrosis due to an embolization of a blood vessel. In addition you can have a "doughnut" effect, i.e, the filler can preferentially lay around the furrow, thus accentuating it more. If it were me, I would only have a physician perform an injection. There are more invasive but less risky options available as well for deeper wrinkles and furrows.  One option is an autologous fat transfer. Small amount of fat is harvested from a thigh, processed and then injected with a blunt cannula under the furrow, this works very well. In addition, one can perform sub-scission, a technique where the dermal attachments are lysed away  from the underlying muscle to release the furrow. The space could be filled with a filler in a much safer and more predictable manner or filled with fat. Finally, if none of the above options have worked, a severely deep furrow could be excised, or cut out and then sutured in a very precise way such that the scar could be imperceptible, certainly less noticeable then the deep furrow. Bottom line, although a quick filler injection could be done, it is not risk free.

Botox or Dysport can be very effective for calming the muscles of facial expression that contribute to the appearance of deep furrows.Sometimes this is all that is necessary to obtain a gratifying cosmetic improvement.

However, after years of muscular contractions, the surface of the skin immediately above these muscles can become permanently etched with lines, just as when a sheet of paper after folding shows crease lines when we unfold and attempt to straighten it. When very deep, these crevaces can have a line-like shadow that makes them appear even more prominent and deep. To remedy this, I routinely use Juvederm XC, which flows smoothly and can be instilled directly under the line to raise it flush with the surface. If the shadowing is very prominent, I occasionally I combine it with a tiny amount of Radiesse to whiten the filler. In addition, to this benefit, the addition of the Radiesse may prolong the life of the correction through its ability to stimulate new collagen formation. Using this technique I have had results that have lasted a year or more after just one treatment session.

The best first-line treatment for a deep creases of the forehead is Botox Cosmetic / Dysport to help relax the underlying muscles to reduce the appearance of creases / wrinkles in the overlying skin.  There are more involved invasive procedures such as a brow lift which can also smooth out the skin of the forehead.  If you post pictures, we may be able to give you more specific advice.  

 

Good Luck.

For most patients, Botox will suffice for forehead wrinkles.
However in some patients when the usual two creases coalesce as one, Botox may be ineffective. Hyaluronic acid filler or autologous fat fascism grafts (LiveFill) are alternatives.
In the frown area, doctors injecting fat or fillers must be cautious of embolic events.

Jeani

There is just no substitute for a personal consultation.  Are you talking about a horizontal forehead line or a deep line between the eyebrows?  This will have a bearing on what your best treatment options are.  Certainly, there are minimally invasive options with fillers and BOTOX.  However, it may be that you have a line that will require surgical options.  Do your home work and find a cosmetic surgeon that treats your concerns and have a personal consutlation.  

Botox is almost always used first to relax the muscles responsible for the furrow.

If the results are not adequate, it can be helped with a judicious use of fillers such as Juvederm, Restylane, Radiesse, and others.