Face at rest. Looks like I’m frowning with deep dent between and above the eyebrow.

Face at rest. Loose forehead skin.

Question: I’ve been dealing with a deep furrow between my brows since I was in my late teens. I spoke with a specialist who suggested Botox. I’ve had Botox a couple times but the furrow persists. I’ve done laser 5 times and no difference. It’s been 5 years since I started battling this and it’s only worsened. Lines/dents have now been created above my brows as well. When I lift my forehead skin up with my fingers my brows raise and the furrows are gone, can a brow lift achieve the same result?

Dr. A’s Answer: It is important that you first ask yourself, “do I want higher eyebrows?”. Above all else, a brow lift is intended to raise the eyebrows. If indeed you would like higher eyebrows, then a well-done brow lift will not only be able to give you higher eyebrows, but it will typically make huge improvements or even eliminate that crease. During a well-done brow lift, the muscle that causes that crease is largely removed, which together with the lifting effect produce the result.

On the other hand, if higher eyebrows is not a desire of yours, then you should look at using a filler like Restylane in addition to the Botox. Typically, a single treatment of Restylane, or perhaps two of them, will create a nearly permanent result, provided you continue Botox. Fillers like Restylane not only directly fill the crease, but if done properly will cause collagen growth that will persist indefinitely if you continue the Botox on an every 3-5 month basis. Realize that if you stop the Botox, in time the new collagen fibers will break down and the crease will return.