Follow-up Botox treatment still not relaxing 11s, do I get another touch-up? (Photos)

Great question. Looking at the picture the line appear pretty deep. So if the other areas: forehead and crow's feet are totally relaxed, it tells you that the injector is most likely doing good job for you and its just the glabellar area that is slow to respond or the muscle is just strong and needs more dose. If the muscle action is gone and wrinkles still bother then you will need fillers to help that area. 

Great question.  If you still have deep lines in the glabella (forehead) after an appropriate amount of botox injection, then most likely you had these present at rest.  This means that the lines are too deep and you require addition of hyaluronic acid fillers in the area such as juvederm.  Best of luck

It can take 1-2 weeks for final results with Botox. Deeper wrinkles would need additional Botox, lasers, microneedling/prp and fillers to get improvement. See an expert. Best, Dr. Emer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  You may require additional botox.  It depends on how many units were injected the first time.  I recommend that you follow-up with your surgeon and share your concerns.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Hi,Your question does not indicate how many units of BOTOX you have received. It may be that you need more. Our goal is not to freeze the forehead as seen in some celebrities, you should still look expressive but the muscles that cause the 11s should not allow those wrinkles when you frown. Every patient is different. We have patients who need 20 units between the brows and others who need 40 or more. If the creases are there when you do not frown, you may need filler to reduce them. Please see a board-certified plastic surgeon for an opinion and treatment. Good luck.

Sometimes patients need higher doses than normal.  Sometimes patients just don't respond well to Botox.  I have a few patient who don't like Botox and prefer Dysport or Xeomin.  Keep working with your doctor to get the results you would like to see.  The 11's can usually be nicely improved.  If your line is "fixed" and there all the time, you may need a little filler too.  Be careful about asking for more improvement of the small line above your lateral eyebrow.  If the muscles are weakened too much your brow will drop and give you and angry look.  Just remember, Botox and fillers are no magic erasers, they just make things a little better.  Best of luck.

I have been injecting Botox for aesthetic reasons since 1991. In the early days, we mistakenly thought that the object of treatment was to "freeze," i.e. paralyze the muscles entirely. After a number of years it became clear that doing so simply created an artificial looking, "porcelainized" smoothing of the treated areas that simply did not look natural. What's more, freezing the muscles led to an inability to emote, something that even a child is able to do. Just say "No!" to any five year old child and you will quickly see those "eleven" lines come out in full force. The object of treatment is to have a relatively smooth area at rest (when not emoting), but still retain the ability to scowl or frown when you want or need to. It is not clear from the photos whether this was achieved for you. If at rest, you are smooth, but are still able to emote then you have been treated properly and sufficiently. I am of course not talking about the "etched-in" lines that form after years of emoting, which often are plainly visible at rest. These do not respond to neuromodulators, but instead require additional treatment with fillers to smooth them. Keep this in mind when consulting with your physician. Best of luck to you.

Hello and thanks for the question.  I would recommend waiting a few more days before returning for follow up. If you are still having movement after 2 weeks of waiting after the touch up then yes I would recommend returning for additional treatment.  
It is unusual to have full movement after two consecutive treatments.  There are some rare patients that do not get a response to Botox. You may also need a higher dose.  
Hope that helps and good luck. 

Botox takes 2 weeks to take full effect.  Perhaps make an appointment to see the doctor at that point to evaluate the results.  You may require a higher dose than usual thus they will be able to determine how many units total you will need going forward with your treatments to achieve the desired result.

There are several types of lines that develop in the face and they respond very differently to Botox or Dysport. A dynamic line comes when you contract the facial muscle and then disappears when you relax that muscle. So in your case when you make a scowl face your 11 lines should appear and look deep. If they are not seen when relaxing then the Botox will not allow you to contract the muscle making the scowl and thus the 11 are gone.
Now static lines are there regardless of muscle contraction. If these 11's are present even when you and resting then they are static and will not go away on a single treatment with botox. Giving more if you are already blocked and can't move then more will not help. What happens is after 4 mo or so you will begin to move those muscles again then get a repeat treatment. After several cycles of botox often the skin works to soften those static lines if not remove them completely.
Finally if after say 3 or 4 rounds of Botox the 11 lines are still there your doctor can carefully inject a thinner filler into that area and fill the lines. Thats not really first line treatment but it works. Just make sure you are going to someone familiar with injecting fillers into that area.
Hang in there I'm sure in time you will be satisfied.