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Wrinkles Between the Eyes: Is Botox Always the Best Solution?

Posted March 18, 2011 in Face, Home

Botox and Dysport are both FDA-approved for reduction of vertical wrinkles between the eyebrows, also known as glabellar wrinkles or 11s.  They work by blocking the nerve impulses to the corrugator muscles (the muscles that squeeze the eyebrows together).

Let’s distinguish two different types of wrinkles:

Dynamic wrinkles: These are the wrinkles that occur only when you contract a muscle.  For example, the corrugator muscles squeeze the eyebrows together, causing vertical wrinkles.  The frontalis muscle raises the eyebrows, causing horizontal forehead/brow wrinkles.

Static wrinkles:  These are the “etched-in” wrinkles that are present all the time. Static wrinkles are often the product of dynamic wrinkles and time.  (Didn’t your mother tell you that if you kept making that face, it would eventually stay?)

Botox is very effective in treating dynamic glabellar wrinkles.  It is also generally effective in treating mild static wrinkles.  However, Botox is much less effective for deep static wrinkles because the skin and subcutaneous tissues are already permanently etched.

Fortunately, if you have deep static wrinkles, there is an effective alternative to Botox.  Restylane, a wrinkle “filler,” works by a completely different mechanism from Botox.  It fills lines (like putty), making it very useful for those lines that are simply too deep for Botox.

For some patients, a combination of Botox and Restylane may be more effective than either product alone.

I personally perform every Botox and Restylane injection.

Before / After (Botox)

Before / After (Botox)


Before / After (Restylane)

Our Botox patients come from Plano, Dallas, Fort Worth, Frisco, Carrollton, Celina, Denison, Wichita Falls, Mesquite, Duncanville, Desoto, Garland, Arlington, Hurst/Euless/Bedford, Irving, Southlake, Westlake, and Las Colinas.  Additional Botox and Restylane before and after photos are available at

For more information, please visit or call us at (469) 306-1774.

Ronald M. Friedman, M.D.

Director, West Plano Plastic Surgery Center

Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas

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