Horizontal Forehead Lines:

We get horizontal forehead lines primarily from our forehead muscles contracting when we raise our eyebrows. Some of us do this as part of our normal facial expressions and some of us (usually over 40) are using these muscles more habitually to hold our eyebrows up to make our eyes look more open. The technique, amount and placement of Botox in the forehead can be tweaked for different individuals based on their expectations and anatomy. The individualized and appropriate amount of Botox in this area can smooth the forehead and also result in brows that are elevated, lowered, kept stationary, or allowed natural movement. As with frown lines, some use fillers in the forehead lines to expedite their resolution. Due to the important arteries that are located in this area, we discourage this option.

 Vertical Frown Lines:

Frown lines between the eyebrows develop over the years as we contract the muscles that make us concentrate, frown or squint. Over time we develop one or several lines or grooves which can remain present when not frowning, and may even persist while we smile!

Frown lines are one of the easiest problems to correct. A small amount of muscle relaxant such as Botox or Dysport will relax the over active muscles (the corrugator and procerus muscles) and over time, reduce or eliminate the wrinkles. The effect should be a relaxed, calm brow. Botox results are noticeable after about 7 days, and usually provide an excellent result. If your lines are significantly deep, repeat Botox treatments at 3 month intervals may be needed for one year so that your new skin after multiple skin cycles can grow out with decreased lines. For immediate results, some use fillers in the frown lines to expedite their resolution. Due to the important arteries that are located in this area, we discourage this option.

 Vertical Forehead Lines(different from Vertical Frown Lines):

Forehead lines that are vertical are usually developed over time from side sleeping where the skin is compressed from one side and creates rippling across the forehead for 6 to 8 hours each night. A special sleeping pillow named Juverest holds the head with a soft foam shaped in a “C” configuration. This prevents the skin from being pushed over and bending repetitively every night, protecting the vitality of the skin. Juverest is available for purchase at our office.

 Temples (and often times lower cheeks):

The sides of our face are often the area we pay the least amount of attention to, but can be the most significant in the overall appearance of emotion and health status. Whether due to exercise, diet, or genetics, the fat in the temples depletes in many individuals and produces a skeletal, tired, withered, and sad appearance. This area can be rejuvenated using different types of fillers, giving a more healthy impression. It can also lift droopy brows.

While off-label, many fillers can work well in this area. Sculptra is like a seed that you plant and stimulate collagen production. It takes 6 weeks for the collagen to grow and produce results. 3 treatments are usually required, each 6 weeks apart, with results lasting over 2 years. The benefits are the smooth,

long lasting

results, with an added safety of injection being in a deeper plane than the major arteries of the temples that feed the eyes and hair. In addition, it’s liquid based rather than gel, hence increasing safety compared to hyaluronic gels if the depositing needle enters a vessel.
When thinner hyaluronic gels such as Juvederm, Vollure, and Restylane are used in this area, they are usually placed superficially (right under the skin). Due to their limited volume in one syringe, a few syringes may be needed to fill the temple area. The benefits of these fillers are their immediate result and ability for reversal. However, superficial injections by nature have a higher chance of an uneven finish, requiring touch up visits. To increase safety around the vessels that live in the superficial layer, we use cannula needles with blunt tips to decrease the chance of entering an artery.

Skeletal hollows vs. rejuvenated soft transitions.