Forehead crease - what will help? (Photo)

Thank you for your question and photo. If you previously had success with Botox injections, you may want to consider another neuromodulator formula such as Dysport, Daxxify, or Xeomin as an alternative. RF microneedling is also a favorable option for minimizing lines and improving the skin’s quality and texture. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or expert injector. They will be able to review your treatment history, assess your concern, and determine the best course of action.

When the Botox used to last longer, were you happy with your results? If so, try a different brand such as Dysport. When fillers are used for vertical wrinkles in the glabella area, this can lead to visible filler product at the injection site. I hope this is helpful! Sincerely, Dr Joseph

"​For glabellar lines (or frown lines / ""11"" lines), we inject Botox, Xeomin, or Dysport into the muscle, causing the muscle to weaken and improving the appearance of the lines. These work by binding to receptors that send nerve signals for muscles to contract. Since your body makes new receptors and neurotransmitters all the time, it needs to be maintained otherwise the wrinkles will slowly return as the muscle regains function over time. Neurotoxins take 2 to 4 weeks to start working and lasts for up to 6 months.

For deeper glabella lines or strong 11s, I use a combination of Botox with fillers, lasers and microneedling with PRP. I suggest getting a formal evaluation with an experienced cosmetic dermatologist and expert in lasers and fillers. Best, Dr. Emer
​"

Hello Lara. Dermal fillers in this area are a great option. With an experienced injector, this area can be dosed safely and effectively with products like Restylane (see link below, second row, third photo from left). Restylane products work very well and last a long time also. We can get up to 2-3 years when the patient is having Botox (Dysport) and dermal fillers at the same time.

You would be wise to be certain that you are consulting with an experienced board certified cosmetic dermatologist to be certain that appropriate concentrations and amounts of the Botox and Xeomin have been given. Perhaps a higher concentration may be needed in this case to handle the dynamic (with motion) muscular action and the static tension (muscular tension at rest) , since some people do develop a kind of resistance to the neurotoxins following several prior treatment sessions. The expert use of a low viscosity, cohesive, malleable HA filler can further help to elevate and smooth the creases that have etched the skin following years of muscular action there. Best of luck.

Hi, thank you for your question! Botox is a great preventative option to help with your 11 lines. Botox is most effective when you treat when 75% of your muscle movement has returned. For most patients, that is receiving a treatment every three to four months. If after a year of consistent botox, other options would be filler and smooth threads. I currently use Volbella off label for the glabbelar lines.

Interesting but not unusual. As we get older Botox seems to be less effective for certain areas. You may benefit from A little filler. Filler lasts much longer 6-12 months and is an excellent way to correct this issue. Filler also agitates your own bodies collagen to help fill this in too.
Hope this helped you a little.Dolores Kent, M.D.

As an aesthetic physician, I would recommend a combination treatment approach for addressing the creases and shadows in the glabellar area. This may involve combining neuromodulators such as Botox or Xeomin with dermal fillers such as hyaluronic acid fillers.
Neuromodulators can help to relax the muscles that cause the creases and shadows in the glabellar area, while dermal fillers can add volume and smooth out the area, helping to reduce the appearance of wrinkles and creases. The combination of these treatments can often provide more comprehensive and longer-lasting results than either treatment alone.
If neuromodulators and dermal fillers are not providing the desired results, other treatment options may be considered, such as laser resurfacing, chemical peels, or micro-needling. These treatments can help to improve skin texture and reduce the appearance of fine lines and wrinkles in the glabellar area.
It's also worth noting that the efficacy of neuromodulators such as Botox or Xeomin can vary from person to person, and may decrease over time with continued use. If you're experiencing a creased or shadowed look despite regular injections, your healthcare provider may recommend adjusting the dosage or switching to a different neuromodulator to achieve better results.
Overall, it's important to have a consultation with a qualified healthcare provider to discuss your concerns and explore the best treatment options for your individual needs. They will be able to evaluate your glabellar area and recommend the most appropriate course of treatment to help achieve the results you desire.

Botox works best to reduce dynamic or movable lines.

It appears that you have a depressed area in the forehead at rest.

Possibly injections of dermal filler carefully can camouflage the depression that you see now.

As you get older if this deep line progresses and becomes more noticeable a brow lift with denervation of the procerus and corrugator muscles will help