Would Dermal Fillers Remove Deep Forehead Lines Unaffected by Botox?

Question

I have tried Botox a number of times and had 2 sessions of Fraxel Restore in part for wrinkles on my forehead. Botox helped a bit with fine lines, and Fraxel Restore seems to have reduced the depth of some of the wrinkles. However I still have some fairly deep wrinkles on the right side of my forehead, and stubborn fine lines over my left and right brow. My lines are all horizontal or zigzag. Would dermal fillers get rid of the deep wrinkles and fine lines on my forehead?

William Franckle, MD, FACS · Answer

Typically dermal fillers are not used on the forehead. Lasers can be a good adjunct to Botox in the forehead. In rare cases you can use fat injections

Sabrina Fabi, MD · Answer

I like to use Botox in conjunction with dermal fillers, as the lines are caused by constant movement, so no matter what treatment you do, nothing will ever get rid of them if the muscles keep moving and bringing the lines back. Once the lines are relaxed I will do a combination of dermal fillers and lasers to soften their appearance. Studies have shown that combining filler with Botox is superior to improving lines created by movement and present at rest than either one alone.

Kenneth Hughes, MD · Answer

If the lines are deep at baseline, Botox can take time to fully soften them. Supplementing with filler in the short term is a good answer. I would recommend going to a place that knows filler well, so as to match the right filler with the areas of concern. Fine lines do better with certain fillers (Belotero, etc) and deeper lines, where more volume is necessary, do well with others (Radiesse in the right anatomical areas, etc). Best of luck.

Donald B. Yoo, MD, FACS · Answer

Dermal fillers are sometimes necessary to soften moderate to deep lines that are not adequately corrected by Botox. Especially for those wrinkles that are "imprinted" into the skin from years and years of wrinkling, a combination of Botox, lasers and fillers are necessary to achieve the best improvement.

Rigo J. Mendoza, MD · Answer

Botox is definitely the best option. Laser resurfacing in addition to the Botox is usually my second option. Fillers in the forehead can have more complications than in other areas. The fillers would help with the deeper wrinkles you still have. I would recommend doing Botox every 3 months, because the lines will continue to improve if you use Botox regularly.

George T. Boris, MD, FRCS · Answer

Filler can be used in the short term to fill lines that Botox will soften after multiple injections. Over time you would not need as much, if any, filler. Best of luck!

Benjamin Barankin, MD, FRCPC · Answer

Botox is a great treatment and preventative for line or wrinkle development where there is movement such as the forehead, frown lines, Crow's feet, and bunny lines. However, if you're starting the treatments once you have deep, etched in lines, then you'll either have to be patient and regularly have Botox for 2-3 years before the lines become more shallow, or add a filler into those lines along with Botox treatments. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Martie Gidon, MD, FRCPC, FAAD · Answer

You have taken the correct approach to treating your forehead wrinkles. Fillers will plump up your forehead lines and will complement your Botox and Fraxel treatments. The zigzag lines may be caused by sleeping on your side and compressing your forehead. These lines can be prevented by sleeping on your back.

Jhonny Salomon, MD · Answer

Botox will work for the fine lines, sometimes when the lines are too deep it works better when in combination with a filler

Stephen Weber MD, FACS · Answer

Botox, as you've learned, is the first line treatment for these dynamic lines. However, some lines do require dermal filler to further plump them. The best result we can achieve with Botox is creation of a relaxed look. If the lines are there when you're relaxed, then there is a chance that Botox and filler might be required to create additional smoothing. I hope this information is helpful.

	Stephen Weber MD, FACS

Would Dermal Fillers Remove Deep Forehead Lines Unaffected by Botox?

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