How Are Deep Frown Lines Treated When Botox Isn't Enough?

This is basically the glabellar furrow. And it doesn't matter how much Botox you do, when there's a furrow there, it's not going to go away. And that needs to be filled. The problem is it's a very tricky area as far as blood vessels. There are neurovascular bundles there. And very appropriately so, a lot of doctors and injectors shy away from this area. They're scared of it. I'm happy about that, because this is a tricky area.

I'm going to demonstrate how this is done. However, I don't want people going and trying this out, because you have to really know the anatomy. During a brow lift, we see the anatomy as surgeons. We know exactly where the neurovascular bundle is. But I'll show you techniques that are safer as well. I'm going to do a Redensity in this area.

Now here, if you can zoom in a little bit. Look, the injection is going straight down to the bone. I am not withdrawing back. I am not aspirating back. There is no need to aspirate back, because the injection is on the bone, and as I'm pulling the needle up, I'm filling the area. So the injection is not anterograde, the injection is retrograde, okay? It's a retrograde injection, but it's vertical.

Why do people get into trouble here? It's because they're injecting this way. First of all, if you've not done this, don't try it. But if you've done it, and you're experienced, and maybe you're a surgeon, a plastic surgeon, the reason that you get into complications is when you do it this way. Because if you go in this direction, you can cannulate the blood vessel. You can go inside the blood vessel. When you go this way, it's not going to happen. It's impossible. Also, you have to know where the supraorbital and supratrochlear bundles are. Where I am is 100% safe.

I do a lot of glabellar injections with fillers. I do a lot of forehead injections with fillers. It's magical, because you can do all the Botox and Dysport in the world, but if you have this laxity, this indentation, it's not going to help. Even if you do a brow lift, it's not going to help. You have to do some fat injections in the area.

And here's the mirror. Grab it with your hands. Now, no Botox yet, no Dysport yet, but just look at this area.

Patient: All the times I've had Botox for the last 20 years, that has never changed.

Right. But look at that. Instantaneous. That valley went away.