Question: What type of injectable filler is the longest lasting for filling out the wrinkles in the forehead? What, if any, complications are associated with injections of this particular filler?

Answer: Well, first of all, I typically do not recommend filling forehead wrinkles since, for the most part, these are dynamic wrinkles, which means that they are there due to overactive muscles, and I do not feel that filler injections tend to last all that long in these types of lines due to the activity of the muscle. I, therefore, typically recommend Botox to these areas as this will dramatically improve forehead lines and though it is a temporary solution, is extremely safe and effective. For patients that insist on a filler, I would first insist that they get Botox and should there be any significantly deep lines afterwards, we could consider filling these areas, but I would not recommend any sort of long-term filler for fear of complications in this area. I would, however, be willing to use a hyaluronic acid filler such as Restylane or Juvederm since these can be reversed should there be any concern about the viability of the skin. In other words, in some areas of the forehead or especially between the eyebrows, if the filler is placed in the skin underneath these wrinkles, it can cause so much congestion to the blood vessels that it prevents oxygenation of the tissue, which can lead to damage to the skin and resulting scarring. This could potentially be reversed if the filler was hyaluronic acid but can really not be reversed if the filler is a longer lasting filler such as a calcium-based filler.