Which Product Do I Use for Vertical Lines? Botox or Restylane?

I have two sort of deep vertical lines right between my eye brows. Which procedure would be better, botox or restylane. Or should one have both procedures on the same site? I am not sure if you can see the vertical line on my picture. I am the one on the right. Thanks.

Doctor Answers 28

Botox for corrugator muscle lines

Texasmom:

Thanks for providing the photo to help our answers. I think the active muscle lines between the eyebrows (corrugator muscle lines) would be ideal for Botox. In fact, that is the area for which the parent company obtained FDA approval for the marketing of Botox. Many of the initial studies were done for that area.

If you did not achieve satisfactory improvement after 2 treatments and 6-8 months time, you might add a filler in addition to Botox. I would not suggest filler alone. Good luck. I think you'll look great.


Greenville Plastic Surgeon
4.8 out of 5 stars 5 reviews

Botox and Restylane

Botox stops the movement of the muscles causing your frown.  Restylane fills in the depressions.  You can have both the same day and if you keep up with regular Botox injections, your Restylane may last for years.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

Botox first for glabellar frown lines

These are the corrugator muscles - when they contract, they form what we call 'glabellar frown lines', these vertical lines of wrinkles. The thing to do is to relax these muscles with Botox. Start there and see what it looks like before you pay for any fillers. Good luck. It should cost somewhere between 250-400 dollars depending on how prominent these muscles are in your case.

Hratch Karamanoukian, MD, FACS
Buffalo General Surgeon
4.9 out of 5 stars 38 reviews

Botox

Botox will relax the muscle of facial expression which cases the wrinkle.  While very effect some deeper wrinkles may require a combination of Botox and filler as you have suggested.

John L. Burns Jr., MD
Dallas Plastic Surgeon
4.7 out of 5 stars 42 reviews

Vertical Line treatment

Botox helps relax the muscles pushing from above your eyebrows towards the center of your brows (corrugators).  The muscles, when not relaxed, forming these vertical line.   Occasionally these lines are very deep and someone may want filler to 'fill' the crevice.  When considering filler in this area, I would consult a specialist to discuss the risks, benefits, and alternatives.

Sean Paul, MD
Austin Oculoplastic Surgeon
5.0 out of 5 stars 16 reviews

For shallow "11" lines, start with botox and add restylane later

Botox will relax your muscles and over a few months, you may find that the lines disappear by themselves.  If they do not, or you want a more immediate result, you can combine Botox with Restylane.  Restylane will fill the depression.  If you get Botox regularly, the Restylane can last a very long time. 

Melissa Chiang, MD, FAAD
Houston Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Botox or Restylane for frown lines

Thank you for your question. The frown lines between the brows can be address two different ways:
1) Botox or Dysport can be used to soften the deepening of the frown lines when making a frown expression. The treatment may even soften the lines that are present at rest.
2) Restylane or Juvederm can be used to soften the frown lines that are present even when you don't make an expression.
For someone who has concerns with both the static lines (without expression) and the dynamic lines (with expression), then using both products would work well together.
I often find that patients who return after a Botox or Dysport treatment in the frown areas complaining it didn't work, is due to the confusion between the static and dynamic frown lines. They continue to see the static lines even though the dynamic lines have softened considerably.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 34 reviews

Botox or Restylane for Glabellar Lines?

Botox is very effective for lines between the eyebrows. As a neuromodulator it works directly on the nerves that innervate the corrugator and procerus muscles of the glabella region (i.e., the vertical and horizontal lines that form between the eye brows).

Jeffrey Weinzweig, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 61 reviews

Botox

Thank you for your question. The general algorithm is that Botox is effective in the “upper ⅓” of the face: forehead lines, crow’s feet, and lines between the eyebrows. These lines are “dynamic” lines, caused by underlying muscle contractions. By relaxing the associated muscles, Botox smoothens the upper ⅓ of the face. “Static” lines in the lower face, such as the nasolabial folds, are amenable to facial filler.
Hope this is helpful. Best wishes. Dr. Shah

Anand G. Shah, MD
San Antonio Facial Plastic Surgeon
4.5 out of 5 stars 13 reviews

Botox versus Restylane for vertical lines

I usually suggest my patients try Botox in this area first, since Botox usually provides good results.  Fillers also have a role in filling deep furrows between the eyebrows but I usually reserve them for patients who want additional improvement after trying Botox.  

William Andrade, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 59 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.