Forehead Wrinkles

What are muscle relaxing injections?

Anti-wrinkle injections can reduce horizontal lines by reducing muscle activity. Over time static lines (lines at rest) will smooth out. Done well, this technique will not be overtly obvious to others.

Simple Botox injections can reduce muscle activity on the forehead.

Treatments take 2-3 minutes to perform, with no downtime required. Muscle relaxing injections typically last 4-5 months.

What is the catch?

The frontalis or forehead muscle is the only muscle holding up your brow. If an inexperienced injector chases the lines, this will result in a clinically significant drop of the brown. By treating the frown lines, this can counteract the relaxation of the frontalis muscle. This not only reduces the feeling of a heavy brow, but also gives a more natural outcome.

In the mature age group, one has to be more careful. In this age we want to LIFT, not relax.

What can dermal fillers do to forehead lines?

Dermal fillers are great in locations such as the cheeks, chin, lips & jawline. I do use fillers in the forehead area, especially the temples. My filler of choice is hyaluronic acid in this location. Fillers displace loose skin & re-establishes the natural curvature of the forehead.

For mid-forehead lines, I place filler either very superficial or deep. The risks of arterial injection are higher in these areas, & hence why I use cannulas. Fillers last between 12 to 36 months. They are best employed with muscle relaxing injections.

Yes, PRE-rejuvenation is important, however the injection intervals may range from 3 to 14 months, depending on your goal & expressivity.

What can laser resurfacing do?

A lot, especially when it comes to static wrinkles & sun damage. For mild forehead wrinkles, fractional laser resurfacing using Fraxel, LaseMD, Frax 1940 as well as CO2 & erbium/ HALO lasers can make a difference.

Deep laser resurfacing can be an option for etched forehead lines.

For epic, deep wrinkles, I use ablative CO2 & Sciton Joule lasers. One treatment can markedly improve wrinkles. Downtime; about 5-9 days.

If you have an element of dynamic wrinkling, a tiny bit of muscle relaxing injectables after laser can make a huge difference.

What can chemical peels do for forehead wrinkles?

Peels are great. Many people underestimate the power of chemical peels. Essentially there are two types of peels-

• Superficial peels: glycolic acid, lactic acid. 5-7 peels over 8-12 weeks. No downtime.

• Medium / deep peels: Jessner TCA peels. One peel, 7–10-day recovery.

Can threads be effective?

In some cases, threads can be effective. My preference is to combine threads with energy devices. My thread of choice is PDO monos. I do not like fixation threads in the forehead area, not because they do not work, but because of the puckering & healing of skin in the fixation points.

What is a natural solution for forehead wrinkles?

A good natural solution for forehead wrinkles that 100% works is to use the by-product of organic bacteria. This bacterium is from the family clostridium. The protein from this organic source is purified, then sealed in a jar with a purple top. It is mixed with some saline & purified water, stirred ever so gently into a clear solution.

This solution is injected into the skin with a very tiny needle. Fast forward a week or two, & wrinkles are relaxed. It works. I promise.

What anti-wrinkle creams can be effective?

The best results are marginal at best. The two best ingredients are retinol/retinoids & alpha hydroxy acids. If you are new to skin care, I suggest the following-

• Retinol 0.1% or retinaldehyde. Apply nightly.

• AHA, preferably glycolic acid ranging from 15 to 20%, in a pH of 2.4-2.6 if you can tolerate this. Apply once to twice a week.

• If you know what you are doing, you can use retinoic acid, or other prescription retinoids such as tretinoin or trifarotene.

Disclaimer: I do not prescribe. You can get this from your doctor / GP, or your dermatologist. My work is entirely procedural in nature.

What has age got to do with what treatments are best?

Lots. As you get older, everything goes down south. In the forehead area, your eyebrows & eyelids get heavier with age. Muscle relaxant injections can only do so much. The older you get, the less you require. Do too much and your eyes will get heavy.

My style is conservative. If there are static wrinkles, I use more units. I really like the look of Cameron, however the can use a wee bit more anti-wrinkle units.

For more mature skin, you require lifting. In some cases, it is brown lift, in others it is brow & upper eyelid lifting.

So, what is the best treatment?

The ideal treatment depends on your wrinkles & age. If you have dynamic wrinkles, the easiest, most cost-effective route is Botox & retinol anti-wrinkle creams

If you have static wrinkles, lasers, surgery & injectables are usually required.