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

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

Answers (10)

Indentations And Depressions Respond Well To Subcision

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. 

    Nelson Lee Novick, MD

    New York Dermatologic Surgeon
    39 reviews

    Fillers may help

    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.

    Indentation on Face and Best Treatment

    To best treat the indentation it is necessary to know the cause of the indentation.  If it is the result of trauma than a facial filler such as Restylane will work well.  If the indentation is caused by your muscle then Botox may work better for your particular situation.  Please consult a board certified dermatologist with experience in Botox and facial fillers for the best result.

    Forehead indentation

    • The photograph suggests the possibility that the indentation is from unusual vertical muscle in the forehead. If so, Botox will work.
    • If the indentation has another cause (it can range from trauma to underdevelopment of tissues in the area), Botox will not correct it but a filler or fat transplant might do so.
    • See a Board Certified Plastic Surgeon for a diagnostic evaluation.
    • Until you know what is causing the dent, don't have treatment. Best wishes.

    Fillers for indent on forehead

    It is most important that you find out what is causing indents on your forehead.  If you had trauma then that can explain it.  However indents spontaneously forming on your forehead could indicate an underlying skin problem.

    If the indents is the result of trauma thin filler injections with Perlane or Juvederm could help.

    Forehead Indentation

    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.
    Jason Emer, MD
    Jason Emer, MD
    Los Angeles Dermatologic Surgeon
    230 reviews

    Forehead Indentations

    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.
    Michael A. Zadeh, MD, FACS
    Michael A. Zadeh, MD, FACS
    Sherman Oaks General Surgeon
    13 reviews

    Fix my forehead indentaton

    The treatment for this kind of isolated indentation in your forehead looks to be the result of soft tissue atrophy either from local trauma, inflammation from an inflammatory lesion like a pimple.  I would suggest for this kind of problem a filler can be very successful. There are a number of great hyaluronic products like Belotero for superficial placement if necessary.  We also like microfat transfer when there is extensive skin atrophy over a larger area.  Try consulting a facility where they can provide you with a range of options. 
    Arthur N. Falk, MD
    Albany Facial Plastic Surgeon

    Forehead Lines

    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.

    Treating indentation on forehead

    I am not certain of the cause of the indentation on your forehead, but Botox would not help with it.  It is possible that a filler could help though.  
    Michael I. Echavez, MD
    Michael I. Echavez, MD
    San Francisco Facial Plastic Surgeon
    18 reviews

    These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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