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I am 32 years old and have two lines between my eyes that are driving me crazy. Is...


I am 32 years old and have two lines between my eyes that are driving me crazy. Is Botox the best solution for this problem?


Botox may be a very simple and suitable solution, but this depends on the severity of the lines and whether there are any related "problems" that you might want to address. For example, if you are bothered by brows that are too low and wanted to address this surgically, then a permanent surgical solution to your vertical frown lines could be achieved at the same time. As you probably know, Botox injections must be repeated periodically to maintain results. Only by evaluation of the actual condition by a qualified, ASAPS-member plastic surgeon can "the best solution" be ultimately determined, since there are several alternative treatments that might prove suitable.


Botox is an ideal treatment for lines caused my moving muscles in the face. Often one deep line or two lines side by side can be smoothed significantly with Botox leaving a person with a younger, refreshed and more pleasant appearance.



Areas of the face that respond well include 'crows feet' lines around the eyes, vertical frown lines between the eyebrows, and horizontal ('worry') lines on the forehead. BOTOX ® can also be administered just below the lateral aspect of the eyebrow to produce a temporary lateral browlift, which opens up and brightens the eyes.


One truly remarkable consequence of BOTOX ® administration that I have seen over and over again is the gradual complete disappearance of deep, vertical furrows between the eyebrows (frown or 'scowl' lines). With long-standing muscle contraction, the vertical lines between the brows may become actual physical clefts or grooves in the dermis, resulting in creases that are still apparent even when the skin is spread apart tightly with a finger on each side of the crease. In such instances, the initial BOTOX ® injection will soften but not completely eliminate the deep furrow. With regular BOTOX ® treatment, however, such that the frown muscles are never allowed to fully regain their normal ability to contract, the deep furrows may gradually fade completely.

Some patients with chronic, deep furrows between the brows achieve improvement but not complete correction of these creases with repeated BOTOX ® injection. In these cases, a soft tissue filler can be used to eliminate what remains of the furrow. I have used Restylane for this indication in a number of patients with excellent results, and for several of these patients I have performed structural fat grafting of the remaining furrow to provide a permanent correction.


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