Filler Between the Eyebrows: Who It Suits, How It Is Done and Its Risks

Frowning and squinting lead to the formation of vertical lines between the eyebrows. At first visible only when frowning, these lines may over time become noticeable even when the face is at rest. The methods most often used for these lines are botulinum toxin and filler. Filler between the eyebrows is the application of a filler containing hyaluronic acid beneath the line to soften the appearance of lines that are visible even at rest. This article explains who filler between the eyebrows is considered for, how it is done and the risks specific to this area.

Which Lines Is Filler Considered For?

• Lines caused by movement: They become prominent when frowning and disappear when the face is at rest. For these lines, the first option is usually botulinum toxin, which temporarily reduces the strength of the muscles that draw the eyebrows together.
• Lines visible even at rest: Long-term repeated movement has left a permanent crease in the skin. For these lines botulinum toxin alone may not be enough, and filler may be considered to support the area beneath the line.

Botulinum toxin reduces muscle movement and does not add volume; filler adds volume beneath the line and does not affect muscle movement. For this reason, the two methods may be planned together in some people. The doctor decides which method is suitable after the examination.

Who Should Not Have It?

The procedure is not performed during pregnancy and breastfeeding, if there is an active infection or cold sore in the treatment area, or if there is a history of allergy to the ingredients of the filler. People with a disease or treatment that affects the immune system first need a doctor's assessment. Blood thinners and other regularly used medicines should not be stopped without consulting a doctor, and the doctor who will perform the procedure should be informed of them in advance.

How Is It Done?

The doctor first assesses the depth of the line with the face in motion and at rest, and decides on the product and the amount to be used. The treatment area is cleaned with an antiseptic solution and an anaesthetic cream is applied if needed. The filler is applied in small amounts beneath the line with a fine needle or a cannula. Because the area between the eyebrows is a delicate area for filler due to its blood vessels, the procedure should be performed by a doctor with thorough knowledge of the anatomy of this area. The effect of the filler is visible immediately after the procedure; the result becomes clearer as the swelling of the first days subsides.

Aftercare

• It is recommended not to press, rub or massage the treated area on the first day.
• Before wearing make-up, doing strenuous exercise or using a sauna or very hot environments, the period recommended by the doctor should be observed.
• Cold compresses can ease swelling and bruising; if complaints do not settle or get worse, the doctor should be consulted.
• The follow-up appointment recommended by the doctor should be attended.

How Long Does It Last?

Fillers containing hyaluronic acid are not permanent; they are broken down by the body over time. How long the effect lasts depends on the person, the skin type, the product used and the amount. When the effect fades, the procedure can be repeated on the doctor's advice. Fillers containing hyaluronic acid can be dissolved with an enzyme if needed.

Possible Risks

Redness, swelling, bruising and tenderness at the injection site are common and usually temporary. Irregularities, lumps, asymmetry and infection are less common. The area between the eyebrows is one of the areas where filler can block a blood vessel. This is a rare but serious complication; it can lead to tissue loss and, very rarely, loss of vision. If sudden and severe pain, whitening or purplish discolouration of the skin, or a disturbance of vision is noticed during or after the procedure, the doctor who performed it or the nearest emergency department should be contacted immediately. For more information, see our face filler and forehead filler pages.

Author: Op. Dr. Yücel Sarıaltın