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Fine lines

Question posted by Tracydeanne from Halifax

I am 42, and have a furrow line between my brows that seems very deep to me.  My mother has the exact same furrow.   What age is appropriate to start looking at options?  I would like to smooth it out and prevent it from worsening.

Doctor's Response

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One thought on “Fine lines

  • Dear Tracydeanne,

    Thank you for your clinical post and this is one of the more common aesthetic concerns that patients initially present with in their 30s and early 40s that is a frown line or frown lines. 
    Affectionately termed Number 11s or frown lines these can often project an image of being angry, or unapproachable.  It is usually from excessive animation of the frown muscles called the
    corrugators and effective early treatment usually involves the use of Botox.  Botox is a very safe chemical that has been used for over 30-40 years that is injected safely as an
    outpatient treatment directly into the muscles that cause corrugation and crunching of the brow area.  Over many years left unchecked these will result in crevices in the skin.  To accommodate the eyebrows as they move together and these will result in your frown lines.  By using Botox you weaken the ability of those muscles to contract and thereby soften the appearance of frown lines.  The nice thing about using Botox early on in the formation of the frown line is that often the frown line will disappear when the Botox administered and the Botox effect will last from 4-6 months.  Generally, repeating the process 2-3 times a year will stop formation and worsening of the frown line and you can be frown line free essentially for the rest of your life.  Occasionally, patients present very late in the development of their frown lines and they are very deep and often require the combination of injectable soft tissue fillers such as Juvederm and
    Restylane in combination with the Botox.  However, it sounds as though you are quite young and simple Botox administration is usually the simplest treatment.

    Other treatments that I perform include radio frequency needle ablation where I ablate the nerve to the muscle itself through a small needle that’s inserted through the skin under local anesthesia.  This will provide 1-2 years of reduced frowning, but is associated with several days of swelling.  The advantage of Botox can be performed in a very short period of time and patients can return right to work.

    Finally, surgical solutions for older patients who also have frown lines and droopiness of the brow an endoscopic brow lift can be performed under local anesthesia.  Using tiny ports
    on either side of the hairline, a small telescope is inserted, the brow is repositioned and the frown muscles that cause the lines are weakened by direct removal and ablation.

    As you can see you have many options to address your frown lines as this is in the earliest stage and you seek non-surgical treatments Botox is likely your best option.  I would seek the advice and consultation of a cosmetic plastic surgeon, cosmetic dermatologist or cosmetic physician with significant experience in all modalities to discuss the best option for you.

    I hope this information has been of some assistance and best of luck.

    For more information, please review our Botox page.

    R. Stephen Mulholland, M.D.

    Certified Plastic Surgeon

    Yorkville, Toronto

Additional Information

Botulinum Toxin aka Botox

Read about the procedure

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