How do I fix the indentation between my nose and forehead? (Photo)

Question

I’ve always had the indentation between my nose and my forehead, what is it exactly and what caused it and how can it be fixed?

Lucas Bryant, MD · Answer

Thanks for your question and photo.  This area has several muscles which can exaggerate or cause significant skin creases. Have you ever had treatment to this area? Treating some of this muscles with botox and raising some of your midline brow/forehead tissues a little bit may be very helpful for you. An in person consultation with a board certified plastic surgeon or facial plastic surgeon may be a good place for you to start. Warm regards.

Michael P. Morrissette, DDS, FACS · Answer

In the one photo that you posted it appears to be more prominent on the left. You may want to consider a CT scan to determine if this is an osteoma.

John Tang, MD · Answer

It appears that you have a strong frown and forehead caused by very active and strong muscles in these areas which causes the indentation of the bridge and has withered away some fat in the forehead (This happens gradually of course).  I would recommend doing Dysport (similar to Botox) in the frown and Botox in the forehead to relax the muscles to help lessen their movement so that it helps to prevent the further deterioration (more indentation).  I would also recommend a dermal filler like Juvederm to fill those indents which will help smooth out the indents.  As always, make sure you consult with an experienced cosmetic surgeon with experience in combining both.  Good Luck!

Jacquelline Leva, DO · Answer

Hi thereIt would seem that you have either a strong procerus muscle there and also possibly anatomical boney landmark creating that bridge in your nose osteoma...I would do ultrasound also palpate the area for any boney abnormalities...if it's all procerus then botox and then a medium g prime filler 0.01 aliquot

Malena Amato, MD, FACS · Answer

Hi, I would recommend less invasive options initially such as a combination treatment of botox to reduce the muscle contraction with filler to lessen the crease. If this is insufficient, there are forehead lifting techniques that may help. Best to consult with a board certified facial surgeon if surgery is indicated. Hope this helps.

Shaun Patel, MD · Answer

The horizontal line at the bridge of your nose is caused by contraction of the procerus muscle. The muscle can be relaxed using a neuromodulator like Botox or Dysport and this would soften the line. The appearance of the forehead could be further improved using a filler like Restylane to address volume loss and Botox/Dysport to improve horizontal forehead lines.

Michael H. Gold, MD · Answer

Thanks for your question and photo – and we always recommend that you have a consultation with a board certified dermatologist or plastic surgeon to evaluate the area and see what is exactly going on with you – which most likely strong muscles in the brow and frown areas.  A skilled injector with one of the neurotoxin can improve this and minimize the look.  Good luck.

J. Daniel Jensen, MD · Answer

You have a combination of two things going on.... First, you have a heavier brow which will have the tendency to cause this line. This would explain the indentation you describe when your facial muscles are at rest. Second, you may have a strong procerus muscle, which pulls the brow down and accentuates this crease. If this line occurs primary when frowning or scowling, it may be improved with some Botox or similar medicine. If the line is present at rest, I would consult with a dermatologist, plastic surgeon or facial plastic surgeon for possible corrective procedures. Fillers such as restylane may be used here off label but there are increased risks due to the way blood vessels are arranged in this location on the face. Only see a very very experienced injector if this is the route you choose to pursue. Good luck!

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