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.
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
Helpful
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
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
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
Helpful