Ask a doctor

I'm 35 years old...What is the best wrinkle treatment for the appearance of "11's"? (photos)

I used to use botox and it worked in my 20's in my 11's area. My plastic surgeons office switched to dysport and the last time I had it done I was not happy with the results. My surgeon suggested it may be time to switch to some sort of a filler since the lines may be more pronounced. Maybe I should go to someone who uses botox again but I really don't like throwing away $$ if it's not going to work. Any suggestions? Is it time to use a filler?

Doctor Answers (11)

Botox for the 11's

+2
I would switch back to Botox.  I would try this first for a few injections performed consecutively, followed by filler if there is no resolve of the prominent wrinkles.  Typically it will soften significantly.  I think Dysport does a great job in reducing movement and giving a natural result, but not so much for the actual wrinkle.  


Chevy Chase Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

I'm 35 years old...What is the best wrinkle treatment for the appearance of "11's"?

+2
YES! Try BOTOX again in amounts of approx. 20 units. I also have found some patients as non responders to Dysport vs Botox... 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

Treatment for the "11's"

+2
Botox is the primary treatment for the "11's".  Dysport or Xeomin can generally give equivalent results to Botox.  Filler can be used in this area if significant wrinkles remain after Botox.  Most of the time, I would not do filler without doing Botox first.  The frown area is considered a higher risk area for vascular occlusion with fillers.  Correct injection technique and correct choice of filler are important in this area.

Richard Ort, MD
Lone Tree Dermatologic Surgeon

You might also like...

"11" lines and filler?

+2
I will often use Botox or dysport to work on these lines. But once they get "etched in" filler may be needed as well. I use Perlane or Juvederm in most patients.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Difference in Neurotoxins and Fillers

+2
Whether you need just a neurotoxin like Botox or Dysport or one of those and a filler depends on what the problems is. The neurotoxins block muscle function and, thus, keep the muscle from contracting and causing the wrinkle. It, therefore, is the primary for the "11's" between the eyebrows. There is not supposed to be much difference between Botox and Dysport, but, occasionally, someone may respond better to one than the other. Also, when a physician switches from one to the other, he may confuse the dosage equivalency. If the muscle is not functioning and the lines are still there, then the lines are etched in the skin. At that point, a filler is also needed to elevate the skin surface to reduce or eliminate the lines. If your surgeon really suggested switching to a filler rather than adding a filler, see someone else. This time find an Expert Injector who really understands the indications for each.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

Treating the "11's"

+2
For the glabellar 11's that you are referring to, I recommend treatment with Botox, Dysport, or Xeomin every 3-4 months to keep up the muscle inhibition.  If you liked Botox better, stick with that.  If there is still a crease there after keeping up your Botox for a year, then I would put a small amount of filler in to soften that a little more.  If you do the filler without doing the Botox, the muscle will continue to contract and the filler there will not last as long.  

Jennifer Janiga, MD
Reno Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

Best treatment for 11 wrinkles

+2
Botox will always be the mainstay of treatment of the glabellar area (11's). In order to prevent deepening of the wrinkles in this area the muscle must be weakened. Fillers will not weaken the muscles. Dysport is not the same strength as Botox so dosing adjustments must be made. When the wrinkles are very deep such as in your case it may not be possible to completely take them away. We can only hope to improve their appearance. In certain situations very little filler can be used to raise the deep folds that remain after Botox has taken effect. However, this should be done with caution by experienced injectors as there are superficial blood vessels in the area. Hope this helps answer your question!

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 4 reviews

Botox or filler

+2
It is always difficult to answer these questions without seeing before and after pictures and also knowing how much product was injected. Dysport is not chemically equivalent to Botox. You could certainly try another round of Botox, which is less expensive before moving on to fillers. In the alternative, as these treatments act in different ways, a combination approach might be worthwhile. I note that you have fine lines on the forehead as well.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 13 reviews

You have a few options.

+1
In general for the Number 11's (and in your case), Botulinum Toxin A, Botox, Xeomin, and Dysport are all equally good to help with the Number 11's.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
5.0 out of 5 stars 26 reviews

Botox vs. Dysport

+1
Botox and Dysport both perform the same function – paralyzing the muscle to reduce and smooth out wrinkles.  However, some patients do tend to prefer one over the other.  If you are unhappy with your last Dysport treatment, I recommend switching back to Botox.  But keep in mind that amount distributed and technique also effects the results.  In addition to Botox, under specific circumstances a filler (such as Restylane) can be injected into the glabella to help fill in and smooth out facial lines.  However, this is a more advanced technique and should only be done with an experienced provider.  I hope that you find this information useful!

Paul L. Leong, MD, FACS
Pittsburgh Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.