Background: With aging, facial lines on the forehead and glabella are sometimes converted from dynamic to static giving an aged appearance. Polydioxanone sutures are popular now as a management option in correcting deep static wrinkles on the upper face. Aim: This work was conducted to assess the synergistic efficacy of combining Botulinum toxin injection with Polydioxanone threads on the upper face static wrinkles. Methods: 30 adult patients with static wrinkles on forehead were included in this work. They were randomly distributed to one of two groups; threads insertion either alone or with Botulinum toxin injection. Treatment efficacy was evaluated after 2 months by using a Global Aesthetic Improvement Scale. Results: Our results displayed a statistically significant improvement in forehead wrinkles in group II compared to group I (P=0.001). There was a trend toward improvement that did not reach significance in glabellar wrinkles in group II compared to group I, but this improvement did not reach the statistical significant level (P<0.112). Conclusions: Absorbable polydioxanone threads can be considered as a third line procedure for wrinkle correction beyond Botulinum toxin and soft tissue fillers. Threads alone don’t fit all situations but their combination with Botulinum toxin can give a better natural-looking appearance with more patient satisfaction.