Glabella Treatment

The glabellar area is where expression lines often form, giving the face an angry or frowning appearance—even when this is not the patient’s intent. In this region, botulinum toxin remains the gold standard treatment, as it improves facial aesthetics by neuromodulating the involved muscles. However, there are cases where toxin alone may not be enough—for example, when the so-called “shadow of the wrinkle” remains visible on the skin, or when patients cannot undergo botulinum toxin for medical reasons, or simply choose not to due to fear. In such cases, a filler can be used either as a complementary or alternative treatment. However, the glabellar area contains terminal arteries, making the risk of vascular complications high.
What’s the proper approach? A very delicate filler must be chosen—one that is not volumizing—and injected superficially. Volumizing products should be strictly avoided, as this area is not suitable for volume expansion: beneath the soft tissue lies bone. Therefore, the filler should be injected at a very superficial level and in minimal amounts to avoid discomfort, pain, and most importantly, poor aesthetic outcomes.