There are many treatment options to address wrinkles of the forehead depending on the severity of the wrinkles. The first line of treatment is skin care which can improve mild wrinkling. At Clearview Plastic Surgery, we are using the Skin Medica line by Allergan. Specifically, the essential serum found in the TNS system works great at reducing the appearance of fine lines by helping to regenerate the deep layer of the skin (the dermis) and by adding a cushion between the two layers of the skin.

If the lines are too significant for skin care alone to eliminate, then the next step would be treatment with a botulinum toxin such as Botox, Dysport, or Xeomin to weaken the muscles responsible for the wrinkles. Most wrinkles are caused by repetitive contraction of the muscles of facial expression which results in a crease in the overlying skin that we perceive as a wrinkle. Weakening them means that there is less repetitive creasing of the skin allowing the existing wrinkles to correct themselves and preventing future wrinkles from developing.

For more severe wrinkles, the next step is the use of dermal fillers like Juvederm or Restylane. These fillers are made of hyaluronic acid, which is a natural substance found in the skin that holds on to water and gives that youthful plumpness that we lose as we age. Injecting a small amount of hyaluronic acid filler directly below some of the forehead wrinkles can help to level them with the surrounding skin. This works especially well in combination with Botox, which by weakening the underlying muscles helps to prevent the natural breakdown of the filler and give a longer lasting result.

If those non-surgical options don’t work the next step would be skin resurfacing. In many cases this will involve a chemical peel, dermabrasion, or a laser treatment, however I personally use the Fractora radio frequency based microneedling device which uses heat to cause the collagen in the dermis to enter a regenerative phase. This results in new collagen formation along with a youthful thickening of the skin and flattening of the wrinkles. I prefer this system to the various alternatives because it is completely customizable to the condition I am treating as well as the downtime that my patients can afford and has a much better safety profile than competing products. Finally, if all else fails, a brow lift is still the gold standard and an excellent and long-lasting answer to severe forehead wrinkles.

While this is the general treatment pathway, no two foreheads are exactly alike, so I will often use several of these techniques in combination to customize the treatment for each patient and help achieve the best possible result. As with everything in plastic surgery, the only way to really know what will work best for you is to come in for a consultation so we can customize a treatment plan for you. Click here to book your consultation today.