I'm 29 and Might Need Botox, How Can I Tell if the 11's Are From Fat or Wrinkles?

I'm 29 years old and have deep vertical lines between eyebrows. I went to a dermatologist not long ago, and pointed it out. She said some overweight people accumulate fat above the eyebrows, and that maybe if I lost weight the lines would diminish. She doesn't offer fillers, so maybe that's why she said that. But my lines are deep "11s". They are embarrassing, and I'm still nursing my son once a day so Botox seems scary. Would Juvederm help? I hear it's safe as it's naturally in our skin.

Doctor Answers 12

Don't be victimized by your dermatologist or cosmetic surgeon.

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The deep vertical lines are much more safely treated with BOTOX or Dysport than with fillers.  Neither treatment should be considered while you are still breast feeding.  Once your baby is fully weaned, then you can have these services.  While both types of treatment we think are very safe, there are not studies that look at the question of what is in breast milk following one of these treatments.  It is not foreseeable that such studies will ever be conducted.  So the most reasonable position it to wait until you are no longer breast feeding your baby.  Fillers to fill in the glabellar lines is associated with a relative high rate of vascular disturbance that can result in skin ischemia or skin death.  This is usually a focal ulceration in the skin that can heal with a scar.  For this reason, treatment of this area with filler is not preferred.  The BOTOX and Dysport treatment are the way to go.  Fat between the eyebrows?  That is a stupid and insensitive remark by your Dermatologist.  Loose weight , great idea especially after pregnancy.  Modify your diet and increase your physical activities are very helpful things.  It will help you look better but you may still want to consider the Botox or Dysport.  These have proven to be very safe treatments.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Botox for Frown Lines

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With the caveat that everyone's anatomy is different,  it sounds as if you would benefit from Botox or Dysport to the glabella (the collection of muscles between your eyes.)  "11's" form from the contraction of these muscles, not from fat.   If the line is still present even when  this muscle is at rest, you can also place some filler there.  I recommend consulting with a reputable injector in your area after you are done nursing your son, as neither of these products are FDA approved while nursing.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews


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The muscles, called the corrugators, around the 11's are huge.  If you contract them, you will see how wide they spread across your forehead.  Once you have stopped breast feeding, have them injected with an adequate amount of xeomin or botox, then see how well the 11's smooth out. They will probably soften nicely.  If not, a repeat dose and ultimately a small bit of filler may be necessary.  All the best, "Dr Joe"

Botox® alone in most cases works very well.

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The 11s between your eyes are almost always due to muscle movement causing a crease in the skin.  Botox® alone in most cases works very well to soften the 11s.  At times, I use a hyaluronic acid filler like Juvederm® or Restylane® to correct the deeper lines initially.  Then, Botox® can be used every 4-6 months to prevent new creases.

Missy Clifton, MD
Bentonville Dermatologist

I'm 29 and Might Need Botox, How Can I Tell if the 11's Are From Fat or Wrinkles?

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Glabellar wrinkles are never from fat as there's no appreciable fatty tissue layer there.  Botox, Dysport or Xeomin will all decrease these unwanted lines and wrinkles.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

See an experienced dermatologist for Botox of the glabella between the eyebrows of teh forehead

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An examination with your muscles at rest and with contraction can demonstrate to the doctor if Botox should help your lines. Some people might benefit from fillers too, but Botox is the best treatment usually for the area between the eyebrows (the glabellar "11"). There are risks with fillers in this area so if you are a candidate for Botox that is what should be tried first and if fillers are being considered, please make sure you have a thorough discussion to learn of the risks.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Botox and breast feeding

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  You have asked a very interesting question.  A photograph would help in providing meaning discussion about the most appropriate treatment options for you.
  The “angry 11’s” are most commonly caused by overactive muscles in the brow and are best treated using Botox as a muscle relaxant.  That being said, Botox should never be used in a patient that is pregnant or nursing. 
  People with deep creases or furrows are best treated with a combination of Botox and Juvederm filler.  I have not come across a case of ‘brow fat” that could not be improved with injectables.  Perhaps a consultation with a provider that was experienced in injectables would be appropriate once you have finished nursing.

Hope this helps.


Christopher Kolstad, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 59 reviews

Options for treating 11's frown lines

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Frown lines (11s) are caused from overactive muscle function in the brow and not from excess fat.  There are three major methods for treating these frown lines. 

The first and least expensive is with Botox.  It's safe ,  very predictable, inexpensive and reversible.  The downside to Botox is that it only lasts from 3 to 4 months.

The second method is to use some type of filler such as Juvederm, Radiesse, Restylane, or fat.  I have seen excellent results with all of the above and even some long term results with fat injections.  The cost for these is a little bit more.

The third option is to surgically cut and remove a small section of the offending muscles.  This is the most permanent solution and the most costly.  The procedure can be performed either endoscopicaly from the hairline or through an upper eyelid incision.

I would wait until you are done breast feeding before contemplating any procedure. 

Robert M. Jensen, MD
Medford Plastic Surgeon
4.8 out of 5 stars 46 reviews

Botox or Filler for Frown Lines

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Your 11's, can be caused by contraction of the muscles between your eyebrows (glabellar muscles) or from shrinkage of tissues. Botox or Dysport can be used at first to see if the wrinkles improve. If the wrinkles do not improve, then a filler can be used. I would wait until you are done nursing before undergoing any treatment.

Adam J. Cohen, MD
Glenview Oculoplastic Surgeon

Botox for frown lines.

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A picture would be helpful in assessing your situation but in most cases frown lines between the eyebrows (the 11 lines) are a result of contraction of the underlying muscle and not from fat.  Perhaps what the dermatologist wanted to convey was if your lines are so deep and present even when you are not actively frowning then Botox alone might not be sufficient to smooth out these lines. Since this particular doctor does not provide these services perhaps you would benefit from another dermatolgist or plastic surgeon who has personal experience providing these services.

Ted Brezel, MD
Long Island Dermatologic Surgeon

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.