Facial Injections: Info, Prices, Photos, Reviews, Q&A

Botox can help remove a deep forehead wrinkles

Botox or Dysport relax the muscle(s) that cause the deep lines in the forehead. However, in order to fully treat deeper lines that have developed over many years, facial fillers such as Juvederm or Restylane may also be used in combination with Botox or Dysport for maximal improvement. (Jen Yuan Chow, MD, Pasadena Facial Plastic Surgeon)

Graduated approach to a deep furrow

Initial evaluation should determine whether this is a static or a dynamic cause. The severity of the furrow should be assessed. Most commonly these represent themselves as “# 11” between the eyes and they are usually vertically or slightly obliquely oriented.

Sometimes you could have a horizontal furrow as well. Some individuals may have a single, very deep furrow. Initial therapy usually includes a trial of botulinum toxin with or without a filler. Caution must be exercised when injecting any filler in this area as it is prone to skin slough or necrosis due to an embolization of a blood vessel.

In addition you can have a “doughnut” effect, i.e, the filler can preferentially lay around the furrow, thus accentuating it more. If it were me, I would only have a physician perform an injection.

There are more invasive but less risky options available as well for deeper wrinkles and furrows. One option is an autologous fat transfer. Small amount of fat is harvested from a thigh, processed and then injected with a blunt cannula under the furrow, this works very well.

In addition, one can perform sub-scission, a technique where the dermal attachments are lysed away from the underlying muscle to release the furrow.

The space could be filled with a filler in a much safer and more predictable manner or filled with fat.

Finally, if none of the above options have worked, a severely deep furrow could be excised, or cut out and then sutured in a very precise way such that the scar could be imperceptible, certainly less noticeable then the deep furrow.

Bottom line, although a quick filler injection could be done, it is not risk free. (Joseph Shvidler, MD, Tacoma Facial Plastic Surgeon)

Options for Forehead Furrow

For most lines (even deep wrinkles), a neuromodulator (Botox or Dysport) is the first line treatment.

However, if the line is deep and present at rest, a hyaluronic acid filler (Juvederm or Restylane) is often also needed to make it go away completely.

An experienced injector should be able to judge whether to use the two modalities at the same time, or to go with Botox/Dysport first and wait on the filler. The good news is that if both modalities are used, the result usually lasts longer than Botox/Dysport alone. (James Bartels, MD, Manchester Facial Plastic Surgeon)

Removing deep lines & wrinkles on your forehead.

A deep forehead furrow can be improved upon, indeed. Sometimes just a little Dysport injection accompanied by a little bit of Restylane filler will do the trick. If the line is vertical between the eyes– this almost always works.

If the furrow is horizontal & across the forehead, you may need more of both products. In any case there is a good chance that you will have a very nice result. Plan to repeat the procedure twice a year & you will note that it gets better each time you do it.

Finally, it takes about 14 days to see the softening (or slow disappearance) of the furrow. If it is exceedingly deep, you may only get a 50% improvement. Then later, after the 2nd treatment, you may reach 75%.

At my dermatology practice we take a good initial photo of your furrow to show to our patients later, so that they can see how good the results are. They’re usually very pleased with the results. (David Colbert, MD, New York Dermatologic Surgeon)

Deep wrinkles can be treated with a combimation of Botox and Filler

Botox or Dysport are typically step one. A filler such as Juvederm or Restylane can be injected for additional improvement. (Michael Sullivan, MD, Columbus Facial Plastic Surgeon)

Botox and Fillers Work Best For Deep Forehead Furrows

Botox or Dysport can be very effective for calming the muscles of facial expression that contribute to the appearance of deep wrinkles. Sometimes this is all that is necessary to obtain a gratifying cosmetic improvement.

However, after years of muscular contractions, the surface of the skin immediately above these muscles can become permanently etched with lines, just as when a sheet of paper after folding shows crease lines when we unfold and attempt to straighten it.

When very deep, these crevaces can have a line-like shadow that makes them appear even more prominent and deep.

To remedy this, I routinely use Juvederm XC, which flows smoothly and can be instilled directly under the line to raise it flush with the surface.

If the shadowing is very prominent, I occasionally I combine it with a tiny amount of Radiesse to whiten the filler.

In addition, to this benefit, the addition of the Radiesse may prolong the life of the correction through its ability to stimulate new collagen formation.

Using this technique I have had results that have lasted a year or more after just one treatment session. (Nelson Lee Novick, MD, New York Dermatologic Surgeon)

Deep wrinkles on forehead best treated with combination of Botox or Dysport and/or fillers

First get an in person consultation with your board-certified aesthetic physician regarding deep lines on the forehead, such as the 11’s between eyebrows. I would consider Botox or Dysport first to minimize dynamic lines, i.e. those caused by involuntary muscle contraction. If there are still noticeable lines at rest, then these static lines, which are valleys between bands of muscles, can be filled in with hyaluronic acid filler such as Juvederm or Restylane which can be reversed if needed.

Keep in mind that filler injection in glabella is an off-labelled indication and make sure that your aesthetic physician is prepared for contingency such as rarely occurred compromised localized circulation which requires prompt action. (William Ting, MD, Bay Area Dermatologic Surgeon)

Botox or Dysport is generally the first line treatment for forehead lines

Deep forehead wrinkles, if caused by facial motion muscles, tend to respond well to Botox or Dysport. If the lines are deep, it may take multiple treatments to achieve desirable results. Fillers can deliver more immediate results but are generally not used first line on the upper face.

Addressing the elasticity of the skin with resurfacing procedures such as chemical peels, laser treatments or topical retinoids can also contribute to a smoother forehead. (Dina D. Strachan, MD, New York Dermatologist)

Is There Help for Deep Furrow Line?

Most often, the term furrow is used to describe the “11” lines in the glabella area, the space above the nose and between the eyes. For this area and these vertical lines, Botox or Dysport is probably your best and first treatment.

In some cases, we find that with deep furrow lines in this area, they may require a little dermal filler as well and we like Restylane. The Botox or Dysport relaxes the muscles causing the line, but when it remains after Botox or Dysport has been injected, then the lines are too deep for just this one treatment and that is when Restylane comes in. (Harold J. Kaplan, MD, Los Angeles Facial Plastic Surgeon)

Deep Furrow in Forehead

If this is a line of animation, Botox or Dysport will help. If the crease is present a rest, fillers or fat injection will improve your appearance. (Richard W. Fleming, MD, Beverly Hills Facial Plastic Surgeon)

Removing a Deep Furrow in Forehead

Botox works very well for diminishing the so-called “elevens” but also the transverse lines in the forehead. I would recommend a consultation with a board certified plastic surgeon who can help you create a plan tailored to your specific anatomy and needs. (Deason Dunagan, MD, Huntsville Plastic Surgeon)

Botox and dysport are indicated for relaxing dynamic lines. They work by relaxing muscles that cause the wrinkles when you frown. In patients that have static line, Botox and dysport will definitely help however you might require higher units to be injected and the wrinkles might not go away completely. (Ben Behnam, MD, Santa Monica Dermatologic Surgeon)