Botox Vertical Forehead Lines
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)
Botox is great
If your wrinkles are only there when you make a facial expression, like frowning, then Botox would be good. If the wrinkles are there permanently, even when your face is neutral then restylane would do the trick.
Some deeper creases can be treated with both. Either way, make sure you do the Botox first. (Michael Constantin Gartner, DO, Paramus Plastic Surgeon)
Vertical lines on forehead requires Botox or Dysport first
Vertical lines on forehead are due to combination of dynamic and static wrinkles. I would consider Botox or Dysport first for dynamic lines which are caused by involuntary muscle contraction then followed by judicious placement of filler if necessary for the static lines due to loss of volume in affected area. (William Ting, MD, Bay Area Dermatologic Surgeon)
Botox/Dysport and Restylane/Juvederm can be a great combo!
For the vertical frown lines between the eyebrows, the combination of Botox AND filler can work better together than either alone.
The Botox works to weaken the muscles creating the wrinkle, and the filler works to immediately lift and smooth the line that would otherwise take months and months and months to smooth out just with Botox alone preventing creasing.
If not, then add filler. Starting with filler alone is an option (especially for someone nervous about Botox) but it’s important to know that the gel filler will physically lift the line but NOT stop the muscles from continuing to try to crease that skin, ultimately leading to a deeper line and the need for more filler sooner than if Botox were there too. (Jessica J. Krant, MD, MPH, New York Dermatologic Surgeon)
For the vertical glabellar lines or frown lines I usually start off with Botox. If they are very etched in, I will add a filler after I see the affects of the Botox. (Steven Wallach, MD, New York Plastic Surgeon)
We only suggest Restylane in this situation if Botox has failed to do the job of smoothing the area. Try Botox first and if there are still some wrinkles left, then try Restylane. Make sure you choose your practitioner based on his/her experience with these procedures before starting. (Harold J. Kaplan, MD, Los Angeles Facial Plastic Surgeon)
Probably the best procedure would be to adminster Botox. These are dynamic lines and respond to Botox (treatment of these lines, the glabella lines, are still the only cosmetic approval for Botox).
Two weeks later you could come back to the office and see whether Restylane might be needed to fill in the slight more superficial lines that remain.
An alternative is to have the fillers plased first and then have Botox injected ( in this order so the Botox does not obliterate the lines). Make sure your physician is experienced at injecting this area.
I would absolutely not let a physician out of the cosmetic core of physicians (plastic surgery, dermatology, oculo-plastic surgery) inject this area. The injections required should be done superficially, slowly with serial puncture technique to prevent embolism into the retinal artery or ischemia.
Sometimes filler can intrude and push the vessels closed causing ischemia (lack of blood flow) and necrosis. Rare but it happens. (Arnold R. Oppenheim, MD, Virginia Beach Dermatologist)
Botox would work to soften the vertical lines, and may or may not eliminate them completely.
Over time, with repeated injections of Botox, any permanent creases that you have in the area may soften to a point that you are very pleased with the results. If not, certain fillers, such as Restylane or Juvederm, can be injected by a physician with experience injecting specifically in this area. (Arash Akhavan, MD, FAAD, Manhattan Dermatologist)
Get Botox first
Most physicians would agree that Botox is the treatment of choice for “11” and if the lines improve only partially, then you can consider having a filler injected. Be certain that you see a qualified experienced physician as there is a risk if too thin a filler is injected into that area.
The safer ones to use are Juvederm and Restylane. Try the Botox first. Realize that the lines are there from years of frowning and the skin developed these creases from the accordion-like motion of the underlying muscles.
Once the muscle stops moving and you don’t frown, it will take time for the skin to lose its crease. The Botox will take a couple of weeks to reach its effect and may last for several months.
Botox and Restylane work best together for vertical forehead lines
Have Botox to treat the vertical “11” lines, and then have either Restylane or Juviderm injected directly into the lines. The filler can be placed either at the same time, or about one week after the Botox.
You will find that even when the Botox wears off, the deep vertical lines should not return. In this area there is a “the sum of the treatments is greater than the individual parts” effect.
Botox, and maybe filler too
Botox will address the “dynamic” wrinkles that occur with muscle movement but not the “static” wrinkle in that location. Fillers, e.g. Juvederm or Restylane can be injected to that vertical line to fill it in.
If you do not lapse in your Botox injections, eventually the “static” vertical line will iron itself out after a few months. Botox and filler can be administered to this location at the same time for convenience, but ideally you would have Botox injected first, then filler 2 weeks later when there is minimal muscle activity in that area. (Bryan K. Chen, MD, San Diego Dermatologist)
Botox is the choice for frown lines, use fillers if the Botox effect is incomplete
Botox weakens the contrraction of the frown muscles called the Corrugator and Procerus muscles. These muscles cause the lines, so when they are weakened, they contract less and the frown lines disappear. Fillers, like Restylane, Juvederm, Radiesse, Perlane, Sculptra and Evolence plump or fill depressions in the skin.
Even with a filler injection, as your frown muscles contract you still will have a noticeable frown line. Thus i always use botox first, because Botox corrects the basic problem that is causing the lines, muscle contraction.
In some patients who have permanent skin indentations caused by frown lines that do not go away with Botox, filler injections can improve the depressed, permanent, skin lines. (Brooke R. Seckel, MD, FACS, Boston Plastic Surgeon)
Botox, Dysport, Wrinkle Treatment, Beverly Hills Botox Dysport, Los Angeles Botox Dysport
For lines between the eyebrows, called the Glabellar area, Botox or Dysport is superior to fillers. Fillers can cause pressure on the thin walled vein traveling along the same pathway as the lines in this area.
If the vein is partially collapsed by the filler, the lack of blood supply can and has caused a quarter-sized hole in the center of the forehead. I have always considered fillers in the glabella to be contraindicated for that very reason.You can always contact the clinical rep at any filler company for further information regarding this risk and complicationas as it is well documented.
So, IMHO, it’s one of the toxins and no Restylane, Juvederm or any filler. (Francis R. Palmer, III, MD, Beverly Hills Facial Plastic Surgeon)
I would recommend a trial of Botox only for your first treatment.
If you maintain yourself with serial Botox treatments, that is every 3-4 months, or as long as it lasts for you, then your skin volume loss directly involved with the lines will correct itself over time.
Fillers in the area will give you a more immediate result, but there are some risks to their use, which you can discuss with your board certified plastic surgeon. (Kenneth R. Francis, MD, FACS, Manhattan Plastic Surgeon)
The best option is to get botox first and wait for 2 weeks. If you get enough improvement then you can avoid fillers. If you continue to have depression and vertical lines then fillers(Juvaderm or Restylane) will work better since your muscles are relaxed and will not fight against the fillers. (Kamran Khoobehi, MD, New Orleans Plastic Surgeon)