How Do I Get Rid of the Horizontal Crease Between my Eyes?

At the very top of my nose, between my eyes is a crease that appears as if my forehead is slipping down, which it probably is because when I put on a tight headband it lifts and softens. Would botox help with this?

Doctor Answers 19

Lift Your Forehead With Botox

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 Because your crease resolves with a headband, it sounds like you need both a Botox brow lift and some filler to even out the crease. Please see a board-certified dermatologist to find out how you can get a more uplifted look with Botox. 


Washington DC Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Botox to address the horizontal line at the upper bridge of the nose

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Thank you for your question Los Angeles2748. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.

It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However I hope that the information provided here is helpful.

The appearance of frown lines is variable from person to person. Usually they are in a vertical orientation but sometimes they can be oblique and sometimes a horizontal line is seen across the upper portion of the nasal bridge as you described. The most common variation is to have two parallel lines, hence the common term "11's" to describe them. But some people have one, three, or more lines. Some people also will see a bulge in the area when contracting the muscle. This bulge is smoothened out after a Botox treatment.

The pivotal studies used 20 units of Botox in the glabella area between the brow to address the frown lines. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary.

Some people have lines at rest (that is without facial expression) which get deeper with facial expression. In these cases, the wrinkles often do not go away completely. However, I find that if patients continue treatments every three months as recommended the wrinkles smoothen out after approximately one year.

With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile. Diffusion of Botox into nearby areas may also be caused by other preventable things. For this reason, I recommend that my patients carefully follow the simple aftercare instructions described below.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids as described above. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Botox is what we call a neuromodulator. This means that it controls nerves to relax the muscles by preventing them from contracting. Botox is the most popular neuromodulator available, has been the most studied, and is cleared for the most number of indications. Other neuromodulators available in the United States include Dysport, Xeomin, and Mybloc. Overseas many others are also available. Each product has slight differences, but all of them work. The majority of our patients find that they like the results of Botox the best. Additionally, Allergan, the maker of Botox, offers the Brilliant Distinctions Program. This is a rewards program where patients receive points from their Botox treatments which can be used toward discounts at subsequent treatments. Points are also received when patients purchase other treatments in the Allergan portfolio including Juvederm Ultra, Juvederm Ultra Plus, Voluma, Volbella, Vollure, and Kybella or products such as Latisse or Skin Medica products.

I find that combining Botox with other treatments or skin care regimens enhances the results and allows patients to enjoy their results for longer. One specific topical product our patients have found to be outstanding in conjunction with a Botox (and filler) treatment is our Hydrating Serum, which contains hyaluronic acid. Hyaluronic acid draws water into the skin and helps to fill in fine lines and wrinkles.

Please consult with a doctor for specific recommendations. Good luck!

Botox would help

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Botox would certainly help this area soften. Consult in person with an experienced injector for an assessment.

Getting Rid of Horizontal Crease Between the Eyes With Botox

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At the very top of my nose, between my eyes is a crease that appears as if my forehead is slipping down, which it probably is because when I put on a tight headband it lifts and softens. Would botox help with this?

 

Most of the time, wrinkles between the eyes are vertical (i.e. frown lines). However prominent horizontal lines are likely to be the result of excess activity with the proceris muscle.  Injecting Botox in this area should help.

You may still see a visible line after the Botox treatment. Botox will only address the muscle component of wrinkles. However, if the line is etched into the skin, a dermal filler might be needed to improve the appearance of this area in a more complete fashion.  

 

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 33 reviews

Botox or Dysport or a hyaluronic acid are good options to treat crease between the eyes.

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The horizontal crease between the eyes is often caused my moving the facial muscles underneath the surface of the skin. A neurotoxin such as Botox or Dysport would be the best treatment for this area. These medications are injected into the muscles to relax the muscles which improves the wrinkle.  If botulinum toxin can’t be used for some reason, or isn’t enough in a particularly deep crease, use of Restylane or Juvederm there would also be appropriate.  If no injectables are desired, I have had some success with fractional radiofrequency device known as eMatrix.

 

Amy Forman Taub, MD
Chicago Dermatologic Surgeon
3.6 out of 5 stars 12 reviews

Botox and the horizontal line between the brows

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Greetingss~

Without seeing you face to face, or a photo, it's difficult to say with any certainty if Botox will help address the crease that you're concerned about.  In some cases, when the procerus muscle between the brows is too strong, or always slightly contracted, it can cause the crease you describe and sometimes it may be a combination of that muscle and gravity and aging.  Filler can help in some cases.  For the best answer for your particular concern consider a consult with a board certified plastic surgeon to review your surgical and non-surgical options.

Good luck~

Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 reviews

Botox first; Fillers or CO2 resurfacing options

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Based on your description, and without the benefit of actually seeing the problem, Botox should be your first step.  Botox is very good for reducing lines at rest and motion in this area.

You may need a filler as well, such as Juvederm, if Botox alone is not completely effective.

To permanently decrease or eliminate persistent lines at rest, a resurfacing procedure, such as fractionated CO2 (Matrix CO2 etc), is your best option.

Jeffrey C. Poole, MD
Metairie Dermatologic Surgeon
4.3 out of 5 stars 6 reviews

Improving crease between the eyes

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I would probably try a little bit of botox combined with a filler such as juvederm or restylane to improve this crease. Have an experienced dermatologist treat you to minimize any potential problems.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

Getting rid of wrinkles between the eyes

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Most likely, Botox will help reduce the appearance of the creases between your eyes. You should consult in person with a facial plastic surgeon to make sure Botox is the correct treatment. If you have more severe sagging, other treatments might be better.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

Botox for horizontal nasal crease

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When the forehead appears to be hanging down as a shelf over the crease, Botox often helps lift the glabella and the line improves. It might be prudent to not treat the upper forehead the same day and ensure that you get a good result because treatment of the upper forehead can cause it to lower and fight against the good result that the botox glabellar treatment provides.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.