Permanent fix for deep forehead lines

Question

I'm 24 but have had these deep lines develop since I was about 16 years old. Are there any treatments that could provide a permanent solution for these deep horizontal lines on my forehead?

Jacob Sedgh, MD · Answer

A combination approach to the deep forehead lines including skin resurfacing and tightening technologies such as fractionated CO2 laser, micro-needling, radio-frequency, combined with injections with Botox and HA fillers is ideal. In refractory cases of severe horizontal wrinkles in older individuals forehead lift surgery can be the most effective option.

Alejandro J. Quiroz, MD · Answer

Thank you for your question. Yes you can permanently removed this lines with surgery nevertheless the use of botox and filler can give you a great result and very long lasting that is to me a better option that surgery since you are so young

Jonathan Kulbersh, MD · Answer

Unfortunately, there is not really a permanent solution for horizontal forehead lines. These lines are caused by muscle activity, so surgery will not be a long-term solution as the lines will come back. Plus, 24 is fairly young for a brow lift procedure. I would suggest Botox to smooth your dynamic lines, and potentially fillers as well if the lines are so deep that they are present even at rest. Please visit a board-certified facial plastic surgeon for an in-person examination to come up with a treatment plan. I hope this helps.

Robert M. Lowen, MD · Answer

Since these lines are present in a young person they are obviously due to deep attachments of the dermis to the underlying muscle. Older people get them from wrinkles and they usually respond well to laser resurfacing or fillers. In this case, it would seem appropriate to free the wrinkle from the underlying muscle. There is an instrument called a ryhtid dissector that does this, and then fill in the space with some fat to fill up the space and keep it from re-attaching. This would be what I would try.

Afshin Parhiscar, MD · Answer

Dear andy9898Unfortunately, there is no permanent solution to your forehead lines that doesnt involve significant risk of complications. Your safest option is to work on a resolution/ maintenance plan of combining botox and fillers to minimize the lines. Brow lifts, lasers, ... are static solutions and your forehead lines are dynamic issues that have to be handled as such. You should certainly see more than one surgeon in consultation and make a well informed decision.

Bhupendra C.K. Patel, MD, FRCS · Answer

Cause: Usually, these are familial (we become, in many ways, like our parents!), genetic predisposition (Greeks, Arabs, etc, have particularly deep lines, more often than other races - the list is long), environmental (exposure to the sun, failure to use sunglasses, etc), and, in the modern world, sometimes related to one's environment, job, etc. Options: Brow lifts are best reserved for patients with other changes (brow droop, visual problems, frown lines, etc. Fillers of various types together with a CO2 laser, which is repeated after six to nine months has given my patients the best results. You can also use dermabrasion for this, instead of the CO2 laser. Botox, if used, should be used judiciously, and in micro-injections to avoid dropping your brows.Good luck!!Bhupendra C. K. Patel MD, FRCS

Kaete A. Archer, MD · Answer

My favorite treatment for deep forehead lines is a neuromodulator such as Botox.  Other brands include Dysport and Xeomin.  Botox works by temporarily relaxing the large muscle across the forehead (frontalis) to improve horizontal forehead lines.  Lines across the forehead set in as the skin is repetitively creased when the eyebrows rise with expression.  This repetitive movement over time combined with early collagen breakdown (genetics, aging, sun-damage) results in forehead lines.  Botox lasts about 3 months.  If you like the result, you would need to continue the treatments.  This is a great option although more than 1 treatment may be required to significantly soften and improve deep lines.  A brow lift can improve deep forehead lines but will not remove them permanently.  I would recommend Botox as a first option, and, in my opinion, is the best option right now for horizontal forehead lines.

Andrew Pichler, MD · Answer

Don't recommend surgery. Muscle attenuators (botox, Dysport, xeomin ) along with fillers (restylane , perlane, Juvederm) are your best options for now.

William Portuese, MD · Answer

At age 24, the best solution is Botox which is a temporary effect. It is not recommended to undergo a  Brow lift  with frontalis muscle thinning at such a young age. For many examples of brow lift procedures, please see the  link and the video below

Kristina Tansavatdi, MD · Answer

I assume you are a man by your profile name and picture. I would discourage against a brow lift for removing the forehead lines at this age and with the current position of your brows. An alternative for a more permanent result would be a permanent filler such as Artefill or autologous fat. A resurfacing procedure (i.e. CO2 laser, dermabrasion, or chemical peel) would also reduce the appearance of the lines.