Dermal Fillers for frown lines
Frown lines are one of the most common areas on the face for injectables. Sometimes after muscle-relaxing injections, the lines are still there and require fillers. Frown line filler is an advanced technique and available at our Sydney clinic by experienced doctors.
When a frown line is being assessed, an important factor to look for is: Is the frown line or fold etched in at rest (ie when the patient is frowning).
If the frown line/ fold is etched in at rest, then if the patient wants a completely smooth area between the brows, then muscle relaxing injections won’t be enough to give that result. Dermal filler will also be required for the frown line. See blog post
The frown line is a very common area to be treated on the face. Patients hate having deep and etched in frown lines. Their family and friends always say
“are you upset”
“are you ok”
These questions can get beyond annoying over time. Those patients with deep frown lines/ folds also hate that it gives them a cranky or negative appearance.
Frown line treatment with dermal filler will make patients look more relaxed and younger and fresher
The frown line is genetically determined and also affected by how much we frown. It will often run in families. Some patients wake up to a deep line because they frown in there sleep all night.
Some people were born to have minimal frown lines, and others were born, destined to have deep vertical crevices between their brows.
For those who weren’t lucky enough to start muscle relaxing injections early enough, it is so simple to just inject dermal filler them to improve the appearance of the etched in lines.
We always encourage patients who have deep frown lines / folds at rest to have some dermal filler injected into the area. It will make them be happier overall with their muscle relaxing injections for the frown line
Frown line filler treatment
How much is required for frown line filler
The dose required for frown line filling would typically be between 0.5 – 1ml
The doctor will assess the face and decide on the best dose after taking a history and examining the patient. If a patient has a history of complications with dermal fillers, or if their budget is small or if they want a more subtle result, then a smaller dose might be chosen to start with.
With frown line injecting, a typical plan for frown line improvement is the following:
Inject muscle relaxing injections
2 weeks later inject up to 1ml of dermal filler
3 months later inject frown line with muscle relaxing injections
2weeks after muscle relaxing injection, inject frown line with dermal filler
repeat this process once more and then after that continue with the muscle relaxing injections every 3-4 months. Often the dermal filler in the frown won’t be required again for several years
Pain relief during treatment
A numbing cream (eg EMLA or LMX ) may be applied to the area prior to the treatment (45 minutes prior is ideal) Glad wrap may be used over the numbing cream to increase its effect.
Local aneasthetic may be injected into the area
There is local anaesthetic in the dermal filler
Ice is always used to decrease pain and to reduce the risk of bruising.
Nitrous oxide (happy gas) is available for patients to use when having fillers for frown lines
What happens during the dermal filler in frown line filler treatment itself?
The face will be cleaned with alcohol and chlorhexidine.
Local anaesthetic may be injected into the frown line area.
A cannula may be used
Ice will be applied to the area briefly before treatment The doctor will inject using a very fine needle. Then pressure with gauze will be applied.
Multiple injections may be required in this area
Technical considerations for injecting
Injecting can be quite difficult, as placement has to be spot on. If the injections are too deep, they won’t lift the frown, but if they are too superficial, the dermal filler will come out the pores while injecting. In cases where this is proving difficult, we will have to inject through many more injection points from different directions etc, to get better filling of the line. This can lead to increased redness and swelling.
Another consideration is that the body does not like to go from having a deep fold / crease / line to immediately being smooth. It must be slowly opened up over time, with partial improvements. Often this is the case with dermal filler in the frown, so it can take up to 3 sessions of injecting dermal filler to get to that flat appearance.
Frown line filler is a very risky area for more serious side effects, so should only be performed by experts.
How will I look after frown line filler?
There may be redness and swelling.
If many needle injections are required, sometimes the forehead can have the appearance of having been “scratched” with 1-2 red lines down the frown lines
There may be bruising and swelling at the cannula entry sites
Side effects /risks with frown line filler
Bruising occurs in a significant number of cases.
Swelling in the injection area will occur. This will last for at least 48 hours
Asymmetry: Sometimes one side is better treated than the other, this is usually because the patient is asymmetrical to start with.
Infection is a very rare complication, but always a possibility when the needle goes into the skin.
Necrosis (blood vessel being blocked, interfering with blood supply to the skin) is very rare. This could lead to scarring.
Need for further treatment: Often with frown lines, it may take several treatments to achieve the results the patient expects
Instructions for care afterward
No makeup for 4 hours
No heavy exercise that day
No acid face products for 24 hours
No spas no saunas, no hot yoga for 1 week post treatment
If there is the “scratched appearance with associated redness down the frown lines that is prolonged, the doctor may suggest using a steroid cream
Cost of dermal filler in frown line:
Cost is per syringe. 1ml is $720-$800
After Frown line filler
What to expect after a frown line filler treatment?
The effect of the dermal filler will be obvious immediately
Most of the swelling from the dermal filler will have resolved by 2-3 days after the procedure. There may be a small amount of swelling for even 2-4 weeks after the procedure.
The result can be reviewed at 4 weeks after treatment and further treatment can be performed if the line isn’t adequately lifted. Often 3 treatments may be necessay
How long will the treatment last?
Dermal filler in the frown line seems to behave a little differently to dermal filler in the rest of the face, maybe because we always relax the muscles associated with the line/fold. Often after 3 treatments are performed, the procedure won’t be required again for several years. Muscle relaxing injections must be continued for this result to be maintained
Cost of Frown Line Filler:
Cost is per syringe. Our clinic has a 1ml minimum, 1ml is from $720-$800