What can I do about forehead lines and wrinkles?
Forehead wrinkles are a common problem often associated with aging but even younger people can have them due to repeated facial expressions, which cause creases to form in the forehead.
Other factors include genetics and environmental exposures such as sun exposure and smoking.
A well-known treatment for forehead lines is the use of a neurotoxin such as Botox, Dysport or XEOMIN.
Other injectable treatments like cosmetic fillers can also be used to improve the contour of the forehead.
Platelet-rich plasma or PRP is also useful for this area.
Brow lifting surgery can also have an impact on the appearance of forehead lines.
Patients complain about their forehead wrinkles because of the visibility of the lines on a large area of the face making you feel that you may have an older looking appearance.
There are two factors which contribute to the development of forehead lines.
One is the continual creasing of the forehead skin due to facial expression and movement.
The other is the progressive loss of collagen and elastin in the forehead skin.
While both causes are seen with facial aging, environmental factors, like sun exposure and smoking, can lead to accelerated breakdown of collagen and elastin fibers in the forehead skin which leads to these wrinkles.
Frequent raising of the eyebrows causing the forehead to repeatedly crease can also make lines on the forehead become visible prematurely.
One important condition which is often results in forehead lines forming is the presence of eyelid ptosis.
Eyelid ptosis means the upper eyelid position is low because of a dysfunction of the muscle, which lifts the upper eyelid called the levator muscle.
Unconsciously people with ptosis are constantly raising their eyebrows to try to lift their drooping upper eyelids in order to see better.
This also occurs with eyebrow ptosis and excess upper eyelid skin or dermatochalasis.
There are several treatments to address decreased collagen and elastin in the forehead skin.
Laser radiofrequency or micro needling can have a smoothing and tightening effect on the forehead skin through the stimulation of collagen production as a response to the treatment.
The principle is that the body naturally produces collagen as an injury response so these medical devices create controlled injuries to stimulate a collagen healing response.
There is also ways to induce collagen production with virtually no injury.
We perform a lot of procedures using platelet-rich plasma or PRP.
PRP is the concentration of wound healing and growth factors present in your blood which are activated for example when you have a cut.
PRP is basically a concentrated form of your body’s natural wound healing factors which stimulates
collagen production as part of the healing process,
The concentrated wound healing and growth factors within the PRP improves overall skin quality, health and thickness.
They often combine PRP treatment for forehead lines with the hyaluronic acid filler using a device and method called skin boosting.
Placing hyaluronic acid into the dermis increases the volume within the dermis to help lines, wrinkles and folds appear less deep.
PRP combined with hyaluronic acid has an also a synergistic effect, increasing the effects and benefits of collagen production.
To treat and reduce forehead wrinkles due to muscle movement I use an injectable neurotoxin like Botox, Dysport or XEOMIN.
Strategic placement of a neurotoxin into a muscle called the frontalis muscle which is responsible for lifting the eyebrows, reduces the activity that causes the deep lines to form.
If you think of the forehead skin as paper the more is crumpled with activity and movement, the more it
creases. B reducing the movement there is less creasing.
With consistent application of Botox, the reduced movement improves the appearance of the forehead lines even at rest.
It is important to have Botox done by an experienced doctor who understands what would look right for you.
It’s common to see overdone Botox in the forehead, resulting in a frozen, unnatural and expressionless look.
In my opinion with just the right amount of Botox placed in the right way, you can improve the appearance of the forehead lines but still allow forehead movement, which comes from natural facial
expressions.
Botox can also be used for non-surgical brow lifting, known as the Botox brow lift to relieve frown lines or the number 11 lines.
Botox is placed in the eyebrow depressor muscles which are the corrugator procerus and orbicularis oculi muscles.
By relaxing these depressor muscles and by strategically relaxing part of the elevator muscle called the frontalis a lift can be achieved while still reducing the appearance of forehead lines.
Surgical brow lifting is also an option to remove redundant skin and raise the forehead skin to help with these lines.
There are several brow lifting techniques which can be customized to the individuals needs.
The surgeons experience and thorough planning prior to surgery are keys to developing a predictable outcome.
Most swelling and bruising from surgical brow lifting lasts about one to two weeks and the healing process like any other surgical procedure continues for a year.
While there are several options to treat forehead lines, for most patients it can be done without surgery and with minimal if any recovery time.
However with time it’s important to maintain results by periodically relaxing the muscles, building on skin quality improvement and sustaining volume to minimize the depth of the forehead lines.
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Rebecca is a licensed aesthetician and certified laser technician with almost 15 years experience in the dermatology. Her life-long passion is making people look good and happy.