Can I Use Restylane Without Botox for Glabellar Lines?

Question

I have late stage Lyme Disease, along with several other health issues, and my Lyme doctor has advised against using Botox anywhere in my body. Would Restylane alone work at all in filling in glabellar lines?

Harold J. Kaplan, MD · Answer

Given your situation, we would most likely be willing to use Restylane alone without the Botox.  To know for sure, we would have to see the region you want treated.

	It is not an optimal solution without Botox, but if your MD has cleared you for dermal fillers and not the Botox, it is a viable alternative.

Lorrie Klein, MD · Answer

While Botox is the best treatment for glabellar lines, Restylane and Juvederm are the second best treatment. While I don't mean to disagree with your Lyme disease specialist, I'm not sure why a small amount of Botox in this area would be a problem for you. There is no contraindication between Lyme disease and the use of Botox that I am aware of. Make sure you go to a specialist who is very experienced in injecting this area. If a filler is injected too deeply in the glabellar area there can be serious side effects. An experienced filler can do it very safely however.

Ron Shelton, MD · Answer

yes, Restylane or Juvederm Ultra may be used in the glabellar region for creases if your doctor suggests that you shouldn't get Botox because of the Lyme disease. The amount of product must not be excessive as this is a risk area for a complication that has been reported a few times. If too thick a filler is used, or too much volume of filler in the glabella, there can be a reduction of blood flow to a sizable region of the mid forehead and that can result in a large scab that can lead to permanent scarring.

Richard W. Westreich, MD · Answer

While botox is certainly the best treatment of choice, I have used fillers alone in this region with success.

	I see no reason why you can not decrease or eliminate the frown lines with filler, rather then with botox, if you have a medical condition that does not allow botox treatments.

	I'm sure your filler, even if it goes away a little faster than usual, will last longer than the 3-4 month duration of botox or dysport.

	Best of luck.

Richard Baxter, MD · Answer

Cosmetic medicine and surgery are like everything else in medicine, in that the treatment needs to be based on a diagnosis of the problem. Nearly all of the vertical wrinkles that appear in the glabellar area are caused by muscle hyperactivity, which is why Botox or Dysport are the first lines of treament. Fillers such as Restylane and Juvederm don't work as well because they don't correct the underlying problem. I am not an expert on Lyme disease so i would respect your doctor's recommendation here, just don't expect the same results.

Steven Wallach, MD · Answer

I have used restylane carefully in the glabella creases to soften the deep lines when Botox has not improved them enough.

Darryl J. Blinski, MD · Answer

Because of your medical issues ANY type of injections whether Botox, Dysport, Restylanee etc. needs approval by the Lyme Disease specialist.

	From MIAMI Dr. B

Hassan Galadari, MD · Answer

Without the use of Botox in the glabellar complex, the filler can dissipate quickly and may even be mobile and does not remain in its right area of injection. It is better to inject Botox first, wait 2 weeks and then have filler injected if the line is indeed deep.

R. Stephen Mulholland, MD (retired) · Answer

Botox is a protein that may have an unknown effect on the immune system and, as such, a lyme disease specialist that advocates no botox is being very cautious (as I am with MS, Lupus, ALS and RA patients who would like to start botox). If it is the opinion of a Lyme specialist that the foreign protein load may not be good for the immune system and the disease process then their opinion must be respected. Regardless, the use of soft tissue fillers, like juvederm, restylane, perlane or radiesse in the frown lines can be a very successful treatment and can greatly soften, or even eliminate the angry lines between the eyebrows.

	It is important to note that the frown muscles will still be powerful and if they cannot crease the skin where the filler was placed in the "usual" fissure line, then patients will be at risk of forming whole new frown lines that may also eventually need treatment............ ultimately, seeking other opinions on your use of botox may be useful and if the answer is "NO-tox", then fillers will have to do.

Can I Use Restylane Without Botox for Glabellar Lines?

Answers (9)

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