Botox or Filler for the 11s?
This is the question almost everyone arrives with, and the honest answer is that for most people the first treatment is not filler.
Glabella lines are muscle-driven. The line exists because the muscle keeps folding the skin, so reducing that muscle activity addresses the cause. Anti-wrinkle injections soften the movement, the skin stops being creased dozens of times a day, and the line eases.
The same principle applies across the upper face, which is why crow's feet and forehead lines respond to the same approach. Where the lines only show on expression, that is usually all that is needed, and adding filler instead would be treating the symptom while the cause carries on.
When Filler Is the Right Answer
Filler earns its place when the line has etched in. If you relax your forehead completely, look in the mirror, and the furrow is still clearly there, relaxing the facial muscles alone will improve it but will not erase it. The crease is now in the skin itself rather than only in the movement.
A small amount of filler placed into that residual line restores the volume the fold has lost and smooths it from beneath.
Why the Two Work Best Together
In practice, deep frown lines usually respond best to the two treatments together, and in that order.
Treating the muscle first with Botox injections and adding filler a couple of weeks later means the filler goes into a line that is already softening, so less product is needed and the result holds longer. Filler placed into a muscle that is still folding it at full strength tends to be broken down faster, and can look worked-on.
When Neither Is the Answer
There is a third possibility worth knowing about. Where lines are fine and the skin quality has thinned rather than folded, skin rejuvenation treatments can be more appropriate than either injectable.
Very deep, long-standing furrows sometimes need laser resurfacing alongside injectables to genuinely change. We would rather tell you that at consultation than take a payment for filler that will only get you part of the way.
Why the Glabella Is a Difficult Area to Inject
The glabella is a small area, but anatomically it is one of the most demanding places on the face to inject, and it is worth understanding why before you choose where to have it done.
The supratrochlear and supraorbital arteries run through this region. Both are branches of the ophthalmic artery, which connects to the blood supply of the retina. If filler is accidentally placed into one of these vessels, it can travel back along that route and block the flow, and the consequences of that include visual complications that may not be reversible.
Along with the nose, the glabella is consistently reported in the medical literature as one of the highest-risk sites on the face for this type of complication.
What Safe Treatment in This Area Requires
This is uncommon. It is not, however, theoretical, and it is the reason the area demands:
- Detailed knowledge of the facial anatomy, and of exactly where these vessels run.
- Careful technique, with small volumes placed slowly rather than quickly and under pressure.
- A medical professional who recognises the early signs that something is not right.
- Hyaluronidase on site, and a protocol ready to use it without delay.
Injectables are doctor-led at PHI Clinic, and glabella filler is carried out by one of our GMC-registered doctors. It is also worth knowing that hyaluronic acid fillers can be dissolved if a result is not what you wanted, so the treatment is not permanent or irreversible.
What Causes Glabella Lines in the First Place
Repeated expression is the main driver, but how quickly the line becomes permanent depends on the condition of the skin holding it. Collagen and elastin are what allow skin to spring back after it folds, and anything that reduces skin elasticity accelerates the process.
The main accelerators are:
- UV exposure. The largest single factor, and the one most people underestimate. Sun damage breaks down existing collagen and impairs collagen production.
- Squinting. Compounds the problem twice over, since bright light both drives the expression and delivers the UV.
- Smoking. Restricts blood supply to the skin and directly degrades collagen and elastin.
- Alcohol and a diet heavy in sugar and processed food. Both affect how well the skin repairs and holds its structure.
- Screen work and concentration. Rarely mentioned, but a face held in a frown for hours a day is folding the same crease thousands of times a week.
Daily sun protection and a decent pair of sunglasses do more to slow glabella lines than any cream marketed for the purpose.
Why Results Differ From Person to Person
The condition of your skin is also why the same treatment gives different results in different people. Filler in well-supported skin sits smoothly. Filler in skin that has lost its structural quality can look uneven, which is part of what a proper assessment is for.
You can read more about how lines form across the face on our wrinkles and frown lines pages.
The Fillers We Use
Glabella lines filler treatments at PHI Clinic are performed using Juvéderm injectable dermal fillers, our range of choice for its consistency and longevity. These are hyaluronic acid based, using a sugar the body already produces, which draws in water to restore facial volume in the area treated.
The glabella needs a soft, finely particled product placed superficially, not the firm structural products used for cheek fillers or jawline work. It is a small-volume treatment, and the aim is to fill the residual crease rather than to add projection to the area.
How long it lasts depends on the product and on how much movement remains in the muscle, which is another reason the two treatments work well in combination.
Your Consultation
Your consultation is with the doctor who would carry out the treatment. They will look at the lines both in movement and at rest, which is what determines whether filler, anti-wrinkle injections or a combination is the right answer, and set out a treatment plan including pricing before anything is agreed.
We leave at least 24 hours between consultation and any procedure. That is deliberate. It gives you time to consider what has been recommended away from the clinic, without the pressure of deciding on the spot.
Why We Under-Treat First
Our approach is to under-treat a concern initially. It is straightforward to add a little more product at review, and considerably harder to undo a result that has been overfilled, so we would rather start conservatively and build.
Subtle treatments age better than obvious ones, and retaining natural lines of expression is what keeps a face looking like itself. If at your follow-up you feel you would benefit from more, tell your doctor and they will advise on the next step.
What to Expect Afterwards
A treatment session takes only a few minutes. The fillers we use contain lidocaine, so the area numbs as the product goes in, and in our experience most patients find it more comfortable than they expected.
There is no downtime in the sense of needing to be at home, but expect some redness immediately afterwards and the possibility of swelling or a small bruise over the following days. Because the area sits between the brows, any bruising here is more visible than it would be lower on the face, so plan treatment ahead of anything you care about being photographed at.
Avoid strenuous exercise, saunas and alcohol for 24 to 48 hours. The result is visible straight away but settles over two to four weeks as the product integrates, so what you see on day one is not the final outcome.
When to Contact the Clinic
Contact us immediately, rather than waiting until the next working day, if you notice:
- Pain that increases rather than settles.
- Any change in skin colour, including blanching, mottling or darkening.
- Any change in your vision.
These are uncommon, but they are the things worth acting on quickly, and any good injector will tell you the same before you leave.
Prices
Dermal filler treatment with our doctors starts from £650. Glabella lines are a small-volume treatment, but the right plan may also include anti-wrinkle injections, and your doctor will set out the full cost at consultation before anything is agreed.
Softer Lines, Without Losing Your Expression
The lines between your brows are part of how your face moves, and the aim is never to erase them completely. It is to take the permanent furrow out of a resting face while leaving the expression that makes it yours.
If those lines have started showing when your face is at rest, book your consultation with one of our doctors at PHI Clinic. We will tell you whether filler is the right answer, whether anti-wrinkle injections would serve you better, or whether it is a combination of the two, including when the honest answer is that you do not need filler yet.
Glabella Lines Filler: Frequently Asked Questions
What are glabella lines?
Glabella lines, also called glabellar lines or the elevens, are the two vertical furrows that form between the eyebrows. The glabella is the flat area of skin directly between and just above the brows, and the lines are made by the corrugator and procerus muscles pulling the brows together when you frown, concentrate or squint.
Can a cream get rid of glabella lines?
No cream will remove a line that stays visible when your face is at rest. Retinoids, antioxidants and daily sun protection genuinely help by improving skin quality and slowing how quickly new lines set in, which makes them worth using for prevention and alongside treatment. But once a crease has become static, the fold is structural, and topical products cannot fill it. Anyone selling a cream that claims otherwise is overstating what it does.
Can I treat glabella lines without injections?
Partly. Sun protection, sunglasses and stopping smoking all slow the process, and being aware of how often you frown at a screen makes a genuine difference over years. For lines that have already etched in, resurfacing treatments such as laser resurfacing can improve the quality and thickness of the skin holding the crease. What none of these do is relax the muscle that keeps folding it, which is why results without injectables are usually partial.
Which filler is best for glabella lines?
A soft, finely particled hyaluronic acid filler placed superficially. This is a small-volume treatment where the aim is to fill a crease, not to add projection, so the firm structural products used to build a jawline or chin are the wrong choice here. We use the Juvéderm range, and your doctor will select the specific product after assessing the depth of the line and the quality of the skin around it.
How much does glabella filler cost?
Dermal filler treatment with our doctors starts from £650. Glabella lines are a small-volume area, but the plan your doctor recommends may also include anti-wrinkle injections, and the full cost is set out at consultation before anything is agreed.
How long does glabella filler last?
Less than filler placed in areas that move less. The glabella is worked constantly by the muscles around it, and that movement breaks the product down faster, so expect to need topping up sooner here than you would after cheek or jawline treatment. Treating the muscle alongside the filler is the most effective way to make the result last, since a quieter muscle is gentler on the product. Your doctor will give you a realistic expectation for the product used.
Can glabella filler be dissolved if I do not like it?
Yes. Hyaluronic acid fillers can be dissolved with an enzyme called hyaluronidase, so the result is not permanent or irreversible. We would normally ask you to let it settle for two to four weeks first, because a good deal of early firmness or unevenness is swelling and newly placed product rather than the final result.