Alternatives to botox for the "11" wrinkles between eyebrows?

A neuromodulator such as Botox, Xeomin or Dysport is your best option at age 28.  For very deep wrinkles a filler may be necessary as well.

Although botox works extremely well for the "11" frown lines between the eyebrows, you can alternatively use fillers or laser for the area. Hylaform gel can be injected into the area to improve wrinkles. Also if the wrinkles are present at rest, laser can be used to help smooth the lines.

Certainly Botox has the longest history for erasing those mid brow frown lines. Proper injection makes a big difference and most experienced injectors seldom see any lid drooping (used to be more common before the injection techniques were changed).But it IS a toxin and if the idea of that is disturbing, then your options are reduced. But, before Botox there was - and still is - a little product called Frownies that theoretically trains you not to frown. The stiff paper is glued to the skin and makes muscle contraction more difficult while wearing it. Obviously best used at home alone or when you sleep but it's usually day events that have your frown going. Does that take the place of Botox? Certainly not, but it's something you could try if you want to go the completely noninvasive route.Other options might be to consciously relax - place a mirror at your desk to check your frown activity and every so often stop what you are doing and close your eyes. Literally TELL yourself to relax and to stop frowning.There is a topical product in FDA trials that is developed for the crows feet. That would eliminate injections in that area but won't address the glabellar muscle that gives you the 11's.Fillers alone probably won't be the best option since you'd still be contracting muscles and creating the lines.Frowning is a habit and like any habit, requires some conscious effort to change.

The frown lines between the eyebrows often need both botox and fillers for the best results. Permanent implants do good in this area as well as temp. fillers. Sincerely, David Hansen,MD

Botox, or other neuromodulators (such as Dysport or Xeomin), is your best option for treating the "11" lines.  Botox is a very well tolerated, and relatively low risk, procedure that provides extremely satisfying results. Serious side effects would be very rare, especially when being treated by a well-trained and experienced injector.  Even if you were to have the rare and unfortunate side effect of eyelid drooping, this is only temporary (and there are ways to make it less apparent in the meantime, if necessary). I would recommend having a consult with your provider to review the treatment, discuss expectations, and address any more specific concerns you have regarding the risks (to hopefully ease your mind!).
Other options would include injecting hyaluronic acid fillers into the area. However, this is a high-risk area for filler injections, and you would definitely need to see an experienced injector with in depth knowledge of facial anatomy. In my opinion, Botox is a much superior option (especially in younger patients with likely less severe wrinkles) than filler for this area due to its lower risk, high satisfaction, and preventative benefits. Fillers would only treat, not prevent, these lines. Less common options for the "11" lines would be resurfacing lasers or microneedling - but, again, I say neuromodulators such as Botox remain the gold standard for this area. good luck!