Static Glabellar Wrinkle - Filler or Botox? (photos)

Botox can relax the frown muscle so the skin won't bend but the existing crack in the skin will only improve by filling it, so combination of Botox and filler is the best for optimal improvement. Filler injection would be safe if injected very superficial.

A
Botox treatment in your frown area will help to decrease these lines, by
relaxing your muscles underneath, even when you are not frowning. However, if
they are very deep lines, they will not go away completely but will look much
less prominent. I do not use filler in this area as there are significant
risks, whereas Botox is safe in this area.

As you've hinted at, Botox is excellent for addressing dynamic wrinkles - those that are created from the movement of your facial muscles.  Movement of the muscles causes the overlying skin to wrinkle, and with constant wrinkling can cause the skin to become permanently creased.  While Botox will help soften your creases, it may be necessary to also have some filler injection to fully address them.

Hi Sparky.  As Dr. Truong points out, we always start with Dysport (Botox).  If the smoothing effect achieved with Dysport alone is not enough for the patient, then we proceed to a dermal filler and we prefer Restylane in this area because it is a softer, smoother gel.  Make certain to find an injector well versed with injecting off label areas with fillers (like between the eyes).  Good luck.

This is a great question. Often, these imprinted lines will improve with Botox only. However, this can take 3-6 months or more. The advantage of Botox is that it is cheaper than filler and addresses the actual problem - muscle movement. You can always add filler later if necessary if those lines don't completely soften. This is a more risky area for filler placement so please seek a Plastic Surgeon or Dermatologist injector for this area. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

With repeated injections of Botox over a period of time, the skin in that area can rejuvenate, but it can be a long, slow process.  An experienced injector can safely treat these crevices with filler to immediately soften them.  Filler along with Botox to stop muscle movement in that area is the most effective treatment.

I usually treat the "11" (Glabellar lines) with neurotoxin injection first, usually 20 Units for a man. then I wait about  2 weeks to see how much they have faded. then I offer to use a filler to fill them out. If you do the fillers before the neurotoxins, the risk is that the filler will form a ridge due to the muscle activity. Make sure that you are going to a well experience injector,since the risks of filler injections in the glabellar region are not null. 

If you have the "elevens" at rest as well as when you make a frown, it is unlikely that Botox alone will fully erase them.  You would be a good candidate to have both Botox and filler.  Filler is safe in this location when the treatment is done by an experienced board-certified cosmetic physician and when done with a hyaluronic acid filler.  Incidences of complications in this region with filler have been seen with use of inappropriate fillers such as Radiesse and poor injection technique.  I usually recommend starting with the Botox first, and waiting a week or two, to decide on filler if you are still concerned.

For the angry 11 lines...start with Botox. This will keep them from getting worse and soften your look dramatically.  As you are no longer deepening those wrinkles on a daily basis with the Botox, you'll likely see the 11's improving with time.  If you don't see enough improvement, a filler can easily be used to filler in deeper furrows.Best wishes, MKB

The lines in your glabellar area are quite deep.  I would start with Botox and wait two weeks to see the full effect. If after two weeks they are still deep you can then add a filler like Restylane to the area.  For the best cosmetic results please consult a board certified dermatologist with a great deal of experience with Botox and facial fillers.