This is a common question among patients who suffer from lines between the brows an area called the glabellum. Filler is not the first line of defense for these lines as it will only mask the true origin of the wrinkle. The glabellum is a muscle group that contracts and causes "elevens" or "furrows" between the brows. A conservative injection of Botox cosmetic at five anatomical locations will allow the muscle to relax, and the furrow to subside.
You have a very common problem and one that is easy to correct so long as you take the proper approach and stick with it.........First you need to use a neuromuscular modifier to prevent both the active and resting tension in the forehead, brow, and glabellar muscles. This will help the muscles relax and greatly slow down the formation of permanent lines in all these areas. You need to do this as often as necessary; which is when the muscle action begins to return. In some people this is 3 months and in others it may be as mush as 9 months. The two drugs I use in my practice are Botox and Dysport....both are excellent.
Second after the muscles are relaxed the residual rhytids or creases then need to be filled with an approved filler such a restylane. Juvederm, or Perlane. Each had a particular period of duration Juvederm and its various preparations lasting longer than Restylane and Perlane .Each has a particular thickness and a prescribed ideal depth of placement. Restylane being the thinnest and the best in very superficial placement and fine thin superficial rhytids. Juvederm is better for wider rhytids, larger dropoffs such as the Nasolabial folds and in the glabellar area.
For your specific problem and photos I would use a combination of Dysport and Juvederm Ultra XC and would see you every 4 months or so to manage the problem as needed
Botox is a great alternative to help prevent future line/wrinkles and can help soften lines on the forehead if they're not to deep to start, its best you seek a reputable Board certified physician for an in-person evaluation to see what may be best for your aesthetic desires.
That is a great question! I would first recommend you have a botox or dysport treatment. Many times this is all that is needed.
There are many fillers on the market. It is more important to find a physician who is very skilled and trained in the injectables(ie botox, dysport, restylane, juvederm, teosyl, belotero, etc). They will help guide you to the proper treatment.
This can be a "tricky" area, so you want to see someone who knows the anatomy(ie dermatologist or plastic surgeon).
Good luck with everything.
Dr. Daniel Radin, Windsor, ON, Canada, dermatologist
Hello Steph. I would definitely try Botox first if you have not done that yet. You may get the results you want with Botox alone. If after 2 weeks of Botox you still have some deep lines remaining then a very small amount of filler can be used to help reduce the appearance of deep lines. I like using Belotero for this because it is a lighter compound that can be injected superficially. This is a very tricky area for filler injection, therefore, it's important that you choose an injector (preferably a surgeon) who has an excellent knowledge of the anatomy of the area. Hope this helps!
Certainly the first treatment you should do is Botox, for which you are an excellent candidate. If after a month they have not smoothed out completely, you can have a small amount of a filler like juvederm xc injected very carefully and superficially. It is important that this is done by an experienced physician injector.
With Botox treatments every 3 to 4 months, the skin can rejuvenate in that area. If you want instant gratification, Restylane-L or JuvedermXC can be used skillfully in the depressions. Filler along with Botox will give you the best and longest results.
Thanks for the photos, you might want to consider doing Botox first to relax the wrinkles and prevent them from worsening. Anything left over after botox can be filled with a hyaluronic acid filler. The facial anatomy is critical here so I would recommend seeing a board certified core physician (dermatologist, plastic surgeon).
Thank you for the photo. For glabellar lines (11's) such as the ones shown in the photo, I would recommend a neurotoxin (Botox or Dysport) coupled with a filler. My filler of choice in this area is Restylane. This is a non-FDA approved use of the filler and injector experience is critical in this area due to the superficial network of blood vessels. In order to prevent problems (vascular occlusion), I routinely pre-inject with lidocaine 1% with 1:100,000 epinephrine in order to vasoconstrict the blood vessels.
I would recommend starting with a Botox treatment to soften the lines and then be reassessed for filler. There are various different filling products that can be used for this area.
Schedule a consult with an expert injector to discuss treatment and concerns.
All the Best!