How to get rid of Procerus Static Wrinkle? (photo)

Question

Hi, Ive had this static wrinkle (believe is called Procerus) for years and Ive had botox before but not gotten rid of it. Is there more botox i could inject into the Procerus muscle to remove it? Or because its static do i have to do fraxel/co2 laser? Ive been on tretinoin for years.

Ella Fedonenko, MD · Answer

Horizontal wrinkle/line on the upper part of your nose bridge could be corrected with a filler(Volbella) or Skinvive.

Eric M. Joseph, MD · Answer

We have not had good success in eliminating these treatments with neurotoxins like botox. A brow lift would do the trick, however, I'm not sure if that is something worthy of undertaking at this stage in your life. Hope this helps! Sincerely, Dr Joseph

Nelson Lee Novick, MD · Answer

I have routinely been treating this very common problem for many years with very gratifying and durable results. Static (at-rest) glabellar "frown lines" of all kinds, be they "eleven lines" or the horizontal line note here, result from two underlying causes, both of which should ideally be treated in order to achieve satisfying and durable results.
The underlying cause of these lines is typically the daily repetitive movement of the muscles of expression located there, which we tend to use numerous times each day. Over the years, especially as we enter midlife, the overlying :"fabric" of our skin becomes permanently etched and creased, so that even when the underlying muscles are at rest, the skin continues to show the "frown lines."  as is the case here.
So, for best and more durable cosmetic improvement, a two-pronged approach is used. Botox can be used to address the movements of the underlying muscles (The intent is not to "freeze" the muscles so that you cannot emote, but rather to diminish their overactivity), and a low viscosity, malleable, cohesive HA filler can be used to elevate and smooth the creases in the "fabric" of the skin. 
In the hands of an experienced, board certified cosmetic dermatologist filler expert, the very superficially placed injections needed to achieve elevation and smoothing of the etched lines typically poses little risk. 
Please note: unfortunately, the hard science to promote the use of so-many of today's expensive, here-today-gone tomorrow light and energy-based gizmos, like fraxel lasers, RF devices, etc, lags woefully behind the heavy marketing and social media buzz that hawks them. So, you would be wise to exercise a whole lot of  "buyer beware" when being presented with these types of options  Hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

Addressing static wrinkles, such as those over the procerus muscle, can indeed be challenging, especially if Botox alone has not been effective. Here are some options to consider:

Combination of Botox and Fillers: While Botox can help prevent further deepening by relaxing the muscle, dermal fillers can be used to fill in the static wrinkle, providing a smoother appearance. This should be done by an experienced professional who can minimize risks and discuss your concerns about fillers.

Laser Treatments: As you mentioned, fractional lasers like Fraxel or CO2 laser resurfacing can be effective for reducing the appearance of static wrinkles. These treatments work by promoting collagen production and resurfacing the skin, which can improve skin texture and reduce the depth of wrinkles.

Microneedling with PRP: Microneedling combined with platelet-rich plasma (PRP) therapy can enhance skin rejuvenation by stimulating collagen production and improving skin texture.

Chemical Peels: Medium-depth chemical peels can help improve the appearance of static wrinkles by encouraging the turnover of skin cells and promoting new collagen formation.

Continued Use of Retinoids: Since you are already using tretinoin, continue with this as it helps in maintaining skin health and promoting collagen production over time.

Consult with a Specialist: It’s important to consult with a board-certified dermatologist or plastic surgeon to evaluate your specific needs and develop a tailored treatment plan. They can provide guidance on the most appropriate and safe combination of treatments for your situation.

Each of these options has its own benefits and considerations, so a professional consultation is key to determining what will work best for you.

Tulsi Kotecha, MD · Answer

Botox is excellent for preventing deeper lines from forming, but once a wrinkle becomes static, meaning it’s visible even when your face is at rest, additional Botox alone won’t erase it.
Smooth PDO Threads – PDO threads can provide subtle structural support while boosting collagen production in the area.
 (RF) Microneedling – A great option if you want to regenerate the skin naturally without adding volume. This treatment smooths out fine lines by rebuilding collagen deep within the skin.
I’d consider smooth PDO threads or microneedling since they are both natural and regenerative methods to stimulate collagen and soften the wrinkle over time.

Viva Eve Dermatology - New York · Answer

Hi!
This is a great question. When was the last time you had any type of tox done for the line?
I would recommend having a few treatments in the glabella and forehead, consistently, as well as incorporate a moisturizer in your routine. This combination of treatment will ensure that the muscle is not causing the skin to crease, and the skin is also being hydrated appropriately since you are on the tretinoin. 
Sincerely,Eleni Sgantzos

Camille Cash, MD · Answer

Botox may help improve the area and then other treatments can be used to boost the results.  You can consider SkinPen microneedling, chemical peels, or lasers.  Begin by visiting a med spa near you for a skin evaluation.  We also recommend using medical grade skin care products like TransformMD and wearing sunscreen every day.

Berat Cigdem, MD - Account Suspended · Answer

A touch of fine hyaluronic acid filler after Botox injections can effectively address the issue.
Important! This area contains vascular structures, making it essential to have the procedure performed by an experienced professional.

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