In this section, we will discuss how physicians are using advanced liquid face lift products including dermal fillers, such as Juvederm® and Restylane®, as well as BOTOX® to treat horizontal lines on the forehead and vertical lines above the nose. The vertical lines above the nose are medically known as glabellar lines because they are located in the glabella region of the face, above the nose and between the eyes. More commonly, the glabellar lines are known as scowl lines or 11's, referring to the fact that they look like the number 11 has been engraved or embossed on the face, giving an individual a scowling appearance.
Note: Before undergoing any procedure discussed on this web site, make sure that your physician has extensive experience with the specific procedure. Medical schools have only recently begun to teach some of these procedures. As with any medical procedure there are varying degrees of risk involved. Please consult your physician.
Scowl lines are an area of concern for many individuals. These lines, technically called glabellar lines, extend vertically above the nose, between the eyebrows. They can look like a number ‘11' is etched into the face. In some individuals, they become pronounced, forming deep folds or furrows. Glabellar lines can contribute to an angry or scowling appearance. The lines are caused primarily by exaggerated scowling, squinting or pensive movement of the eyebrows and forehead.
Glabellar lines are treated by most doctors with BOTOX®. Treatments with BOTOX® in this area typically require around five quick injections with a very fine needle. As with other BOTOX® procedures, if the treatments are maintained regularly, many patients will require smaller amounts over time.
Patients with folds or deep lines may need a combination of BOTOX® and dermal fillers, such as Restylane® or Juvederm®, in this area. It is important to use a physician who is highly experienced with dermal filler injections when receiving treatment in the glabella region. Since BOTOX® is such an effective method of treatment for glabellar lines, most physicians recommend that patients begin receiving BOTOX® treatments before the lines turn into deeper folds or furrows.
Horizontal wrinkles that form on the forehead are common to many individuals. They are generally called forehead rows. These lines are caused by repeated exaggerated lifting of the eyebrows and forehead. Exposure to sun and the environment can make the lines become more pronounced or etched over time.
Forehead lines are typically treated by most physicians with BOTOX®. Applications of BOTOX® are placed at various points across the forehead into specific areas of the frontalis muscle that extends up and fans out from the eyebrows. The goal is to diminish exaggerated movement of the forehead. In most instances, experienced physicians will leave adequate movement of the forehead, so that an individual does not have a frozen look and can make normal expressions.
Physicians use a very fine needle in a range of injection points. The number of injection points will vary, given the depth and number of lines, and to some extent, given the physician's own particular preferences. After the physician assesses the face, the actual injection procedure is very quick, usually taking one or two minutes.
If a patient is diligent about returning to the physician as soon as full movement returns to the region, then over time, the lines will typically relax and lose some or all of the etching. For many individuals, the number of units of BOTOX® required to maintain a line-free forehead becomes fewer and fewer over time.
In addition to BOTOX®, if the forehead lines are deep, then an advanced dermal filler such as Restylane® or Juvederm® may be applied to gently lift part of the grooved line. Together with BOTOX®, the dermal fillers will last an extended period of time, in many instances.
Advanced Dermatology PC of NY & NJ Commack, Commack, NY
W. Grant Stevens MD FACS, Marina Del Rey, CA
Vincent C. Giampapa MD FACS, Montclair, NJ ~ Tina S. Alster M.D., Washington DC, DC
Vivian W. Bucay M.D., San Antonio, TX ~ David K. Funt M.D. NY, Roslyn, NY
George J. Bitar MD, Manassas, VA ~ Gilbert Lee MD, San Diego, CA
Jess Prischmann MD, Edina, MN ~ Carlos Wolf M.D., Miami, FL