Cause of vertical depression lines on forehead? Been receiving Botox every 3 months for 1 1/2 years. (photos)

Question

I’ve been receiving Botox, every 3 months, for 1.5 years to treat deep, horizontal forehead lines. Most recently, I had about 38-40 units Botox on Nov 28, 2017 to forehead. Botox results do not last long for me; it wears off after 2 months. Currently, I have a depressed line that runs down my forehead. All pictures were taken on different days or weeks. Some days the depressions are more noticeable than others. Can anyone tell me what these are and why I get them?

Christopher J. Davidson, MD, FACS · Answer

Thank you for your question and photograph.  The vertical line that you are describing is likely structural.  Botox cosmetic in the forehead, or frontalis muscles is used to soften horizontal lines.  Best of luck.

Monika Soni, MD · Answer

Thank you for your question. I see the area you are concerned about, unfortunately, without examining you in person it is difficult to determine what the cause of your vertical line is. However, this can be treated with Botox or dermal fillers. I recommend having a follow up with your injector to address your concern. Best of Luck!

Leo McCafferty, MD · Answer

I don't believe the vertical depressions on your forehead can be helped with Botox.  This appears to be a mild thinning of the soft tissue in this area.  I would recommend a hands on exam for an accurate diagnosis and possible solutions.

Aurora DeJuliis, MD · Answer

Vertical lines are created when you sleep on your side and usually they start to become prominent as you age. Botox works best for horizontal lines but an experienced physician can help to minimize them by placing Botox or Xeomin in the right place.

Gary Gesualdi, MD · Answer

I definitely see what you are talking about.  Wondering if that is a natural contour of forehead bone that is only now becoming visible because of skin losing some of its collagen and "fullness" over time.  Best bet for you is get a face to face consult with a seasoned injector who has the experience and has seen many variations of peoples boney structures and asymmetries.
In case worried this very mild depression is not caused by your Botox injections.
Good luck and there is hope that a little soft filler can be injected superficially to lesses the appearance.
If get treated please post a picture so we all can learn.
Thanks for question
Gary Gesualdi, MD
Chattanooga, TN

Leonard Grossman, MD · Answer

it appears that the depression that you're seeing maybe a path for a blood vessel through which it runs. I believe you will need an in-person consultation and I would definitely follow up with your treating physician. Good luck from New York City

Cause of vertical depression lines on forehead? Been receiving Botox every 3 months for 1 1/2 years. (photos)

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