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Do Fillers Last Longer in Forehead Frown Lines Than Botox

Posted: 6:00 a.m. Sunday, April 22, 2018

By Anita Mandal, M.D.
Question: I have strong frown lines between my eyebrows that I get Botox injections for. Since fillers last longer than Botox, can they be injected into these lines for a longer lasting result?

Answer: The answer is both yes and no. The frown lines between the brows, also known as glabellar lines, are caused by the force of overactive glabellar muscles on the skin. As the skin ages and loses collagen and elastin, the skin can no longer resist the force of these muscles and gives in by forming wrinkles.

Not all wrinkles are the same in that different wrinkles have different causes. Since glabellar frown lines are mainly due to overactive muscle activity, they should typically be treated with Botox which relaxes the muscles by inhibiting the messages sent to our muscles from our nerve endings.

Fillers can improve glabellar frown lines but work best when used in combination with Botox rather than alone. Patients who can get a worthwhile result from injectable filler treatments are often those who have seen some improvement from Botox but still have residual lines or grooves in the glabella.

When glabellar muscle forces have been acting on the skin for a prolonged time, the skin wrinkles cannot always completely smooth out after Botox. Some patients mistakenly conclude that their Botox didn’t work.

An experienced Botox injector can determine whether the residual depressions or grooves after a botox treatment can be improved with additional Botox or if the Botox has reached its maximal effect and an injectable filler is needed for additional improvement.

In patients with residual grooves or depressions after Botox, the 5-year filler Bellafill or Radiesse, Restylane Lyft or Juvederm Ultra XC can be effective in combination with Botox. In those with residual lines rather than grooves, a more superficial filler such as Restylane can be used with combination with Botox.

Injectable filler treatments in the glabellar area must be done with great caution and by a very knowledgeable and experienced injector to reduce the risk of complications.

It is also important to realize that injectable fillers alone are usually not a substitute for Botox treatments and are typically needed in combination with fillers. When fillers alone are used for glabellar grooves or lines, the filler tends to go away much sooner due to the overactive muscle forces. However, if Botox treatments are maintained at regular intervals, the filler can remain in place for a much longer period of time.

A thorough consultation with a Board Certified Facial Plastic Surgeon is the first step in determining whether Botox alone or a Botox and injectable filler combination can give you optimal results.

 

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