My glabella is in a permanent frown and it is very ageing. I have had Botox to relax it but it didn't work. I had acne when I was younger and it was very severe in that area so it is quite scarred. I was told that filler is too much a risk as there is an artery there. I am not keen on thermage or ultherapy as it seems people have had bad experiences on here. I just wanted to ask some experts for their opinions/recommendation.
Answer: Dermal filler Hi @Ibk83! If you have a permanent wrinkle on your glabella that cannot be addressed with Botox, I would recommend a hyaluronic acid based filler. That being said, the glabella area is a risky area to inject dermal fillers. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications.
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Answer: Dermal filler Hi @Ibk83! If you have a permanent wrinkle on your glabella that cannot be addressed with Botox, I would recommend a hyaluronic acid based filler. That being said, the glabella area is a risky area to inject dermal fillers. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications.
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August 28, 2017
Answer: Deep Furrows in the Frown For the deep furrows, I would recommend that you add fillers to the Botox. Fillers can be injected to this area safely with the right technique. It can smooth out this area because you need some volume. If you like the result then you will need to do the Botox with filler as the Botox will help protect the filler from being worn down by your muscles. As always, find an injector with the skills and experience to give you the best result with the lowest risk as possible.
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August 28, 2017
Answer: Deep Furrows in the Frown For the deep furrows, I would recommend that you add fillers to the Botox. Fillers can be injected to this area safely with the right technique. It can smooth out this area because you need some volume. If you like the result then you will need to do the Botox with filler as the Botox will help protect the filler from being worn down by your muscles. As always, find an injector with the skills and experience to give you the best result with the lowest risk as possible.
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August 28, 2017
Answer: Glabellar area So to give you a good recommendation one has to look at the area in static and dynamic state to see if theses are dynamic or static wrinkles. Regular botox does help in softening the wrinkles but if these are static then fillers is a great option and they are completely safe in that area. Every part of the face has arteries so the technique is important but in good hands can give you excellent results.
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August 28, 2017
Answer: Glabellar area So to give you a good recommendation one has to look at the area in static and dynamic state to see if theses are dynamic or static wrinkles. Regular botox does help in softening the wrinkles but if these are static then fillers is a great option and they are completely safe in that area. Every part of the face has arteries so the technique is important but in good hands can give you excellent results.
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August 29, 2017
Answer: Permanent frown lines I'm sorry to hear that your battle against glabellar frown lines has been unsatisfying so far! The corrugator muscles that act in this area can be very strong and years of making expressions that activate them (frowning, concentrating, looking at a monitor for long periods) along with acne scarring can make treatment a little more involved. Botox is an excellent first step to take. Have you only had Botox here once? I often tell me patients with deep furrows in this area that they may need several treatments to get the creases to smooth out. While you are correct that there are arteries here that can lead to tissue necrosis if injection is done without proper respect for the anatomy, filler or fat transfer can make a big difference in improving the contour in tough to treat cases. I would have to examine you in person to assess the extent of your scars here, but subcision (releasing the deeper bands of scar tissue that are causing the furrows) may be an option too. This can be done alone but for acne scars, this coupled with superficial filler (far away from those arteries) can give excellent results. If you are nervous about filler or fat transfer (and that's totally fine!), you could consider microneedling with PRP to penetrate the deeper layer of dermis where the scar has done its damage and encourage new collagen growth as well as increased blood supply. PRP (platelet rich plasma) is chock full of growth factors that boost the effect you get with microneedling alone. More invasive options are also available - surgery can be done to debulk the corrugator muscles so that they are weaker and cannot pull to create deep wrinkles. Regardless, please choose a qualified, experienced injector or a plastic surgeon who understands the anatomy in this area. At your consultation, make sure your concerns are heard. A good physician always puts safety first! I hope this helps. -Dr. Leong
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August 29, 2017
Answer: Permanent frown lines I'm sorry to hear that your battle against glabellar frown lines has been unsatisfying so far! The corrugator muscles that act in this area can be very strong and years of making expressions that activate them (frowning, concentrating, looking at a monitor for long periods) along with acne scarring can make treatment a little more involved. Botox is an excellent first step to take. Have you only had Botox here once? I often tell me patients with deep furrows in this area that they may need several treatments to get the creases to smooth out. While you are correct that there are arteries here that can lead to tissue necrosis if injection is done without proper respect for the anatomy, filler or fat transfer can make a big difference in improving the contour in tough to treat cases. I would have to examine you in person to assess the extent of your scars here, but subcision (releasing the deeper bands of scar tissue that are causing the furrows) may be an option too. This can be done alone but for acne scars, this coupled with superficial filler (far away from those arteries) can give excellent results. If you are nervous about filler or fat transfer (and that's totally fine!), you could consider microneedling with PRP to penetrate the deeper layer of dermis where the scar has done its damage and encourage new collagen growth as well as increased blood supply. PRP (platelet rich plasma) is chock full of growth factors that boost the effect you get with microneedling alone. More invasive options are also available - surgery can be done to debulk the corrugator muscles so that they are weaker and cannot pull to create deep wrinkles. Regardless, please choose a qualified, experienced injector or a plastic surgeon who understands the anatomy in this area. At your consultation, make sure your concerns are heard. A good physician always puts safety first! I hope this helps. -Dr. Leong
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August 28, 2017
Answer: Botox did not fix my glabella issue, what are my other options? fillers Hello Thank you for asking this question. It seems Botox has done good job for your forehead. Assuming your glabella doesn't have any movements then fillers definitely would be a good option and give you immediate results. I have performed filler in the glabella area for fixed non-resolving 11 after botox and no adverse event seen. Experienced physician and good choice of a filler are important factors and it should be good to go. Hope the best
Helpful
August 28, 2017
Answer: Botox did not fix my glabella issue, what are my other options? fillers Hello Thank you for asking this question. It seems Botox has done good job for your forehead. Assuming your glabella doesn't have any movements then fillers definitely would be a good option and give you immediate results. I have performed filler in the glabella area for fixed non-resolving 11 after botox and no adverse event seen. Experienced physician and good choice of a filler are important factors and it should be good to go. Hope the best
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