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.