How can the indentation on my forehead be treated? (photo)

Question

I am 21 and am rapidly developing indents in my forehead. I am considering botox and dermal fillers

Nelson Lee Novick, MD · Answer

The photo suggests the presence of one forehead indentation. If this represents an indented or depressed scar subsequent to trauma to the area, then subcision with or without the addition of a volumizing filler would be an easy and viable option for treating the condition. However, if there is no prior history of trauma, infection or inflammatory process, the underlying cause must be determined and addressed before embarking on any aesthetic treatments. Consultation with a board certified dermatologist is highly recommended. Once more serious medical conditions have been ruled out, subcision might be considered for treating the indentation. For over twenty years, subcision has proven an easy and effective method for permanently elevating depressed scars of various types. Subcision is a procedure in which a sterilized needle is inserted, following the administration of local anesthesia, directly beneath a depressed scar (regardless of whether from acne, infection, trauma, or surgery) and used to break up the thick bands of fibrous scar tissue that bind down the surface and create the depression. On a small, linear scar, such as this, treatment would likely take no more than a couple of minutes.Breaking up the abnormal bands of thickened, scar collagen accomplishes two things. First, it allows the surface of the scar to float to the surface. In addition, the tissue fluid that immediately fills the space following treatment contains growth factors and other wound healing substances that promote neocollagenesis, native collagen production, that allows for improvement and elevation of the scars. Between two to four treatments, spaced at six week intervals, are generally required to promote sufficient new collagen to achieve a satisfactory improvement. Since, the collagen produced is one's own, the results of subcision are typically permanent. To further plump the depression and stimulate additional collagen production, a small amount of volumizer filler, such as Radiesse or Radiesse combined with Perlane L may be injected immediately following subcision treatment or between treatment sessions.

Jerome Edelstein, MD · Answer

Fillers are usually used rather than Botox to raise indentations to make them more even with the rest of your skin. However, a physical exam would be required to determine if this would be effective or another treatment.

Jason Emer, MD · Answer

Indentation on the forhead can be cause from a variety of pathological processes and should be evaluated by a dermatologist prior to any cosmetic treatments.  Fillers work great in this area, for this specific reason, although botox has a very limited role.  I would see a dermatologist with expertise in treatment of scars, facial asymmetries and alternative areas, as injections in this area can have complications if not performed correctly.  There are conditions called en coupe de sabre and Parry-romberg that I have treated on many occasions that cause facial asymmetries and have required permanent fillers.  But you should try something more reversible when first undergoing treatment.  I wish you the best of luck, Dr. Emer.

Michael A. Zadeh, MD, FACS · Answer

Botox works well for dynamic wrinkles or indentations which appear or are worsened with muscle movement. It's difficult to judge with just the one picture you provided, but this does not seem to be the case with your forehead indentation. In your case, I think a filler such as Belotero or Juvederm will work nicely to raise the dent and get it closer to the level of the rest of your forehead. Make sure you consult with an experienced physician who can do a full examination and determine which treatment options will work for you. Good luck.

Maisam Fazel, MA, MBBChir, FRCS · Answer

It is difficult to assess your forehead indentations without a clinical exam. Botox would only help if the indentations are dynamic (become worse with facial muscle movement). Fillers on the other hand may help if the indentations are static.

How can the indentation on my forehead be treated? (photo)

Answers (10)

Answer: Forehead Indentations

Answer: Forehead Indentations

Answer: Forehead Lines

Answer: Forehead Lines

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How can the indentation on my forehead be treated? (photo)

Answers (10)

Answer: Forehead Indentations

Answer: Forehead Indentations

Answer: Forehead Lines

Answer: Forehead Lines

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Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.