Last updated: 02/17/2009

Soft tissue fillers

Alternatives to surgical treatment for frown lines and wrinkles of the forehead include injections of filler materials under the skin to smooth wrinkles or injections of botulinum toxin to paralyze the facial muscles...

involved in frowning or brow wrinkling. The most commonly used filler materials are collagen and fat. Collagen is a protein found in human and animal connective tissue that makes the tissue strong and flexible. Most collagen that is used for cosmetic injections is derived from cattle, which produces allergic reactions in some people. Fat injections use fat taken from the patient's abdomen, thighs, or buttocks. The fat is then reinjected under the skin of the forehead to smooth out lines and wrinkles.

One drawback of both collagen and fat injections is that the effects are not permanent. Some new injectable filler substances are said to be permanent wrinkle removers. They include Artecoll, which contains small plastic particles that supposedly stimulate the body to produce its own collagen; and Radiance, which is made of a chemical called calcium hydroxylapatite. Still other injectable tissue fillers are made from synthetic hyaluronic acid, which has been used for a number of years to treat joint pain. Since hyaluronic acid is produced naturally in the body, allergic reactions to this type of tissue filler are relatively rare.

Botulinum toxin

Botulinum toxin is a compound produced by the spores and growing cells of the organism that causes botulism, Clostridium botulinum. The toxin causes muscle paralysis. It was first used clinically in the 1960s to treat neurological disorders but also proved to be effective in paralyzing the facial muscles that cause "crow's feet" and frown wrinkles. Botulinum toxin, or Botox, was approved by the Food and Drug Administration (FDA) in April 2002 as a treatment for facial lines and wrinkles.

Both soft tissue fillers and Botox injections are regarded as effective though temporary alternatives to a forehead lift for reducing frown lines. Collagen injections must be repeated every three to six months, while Botox injections are effective for about four months.