I have had Botox twice and still have 11’s (frown lines) Can microneedling help? (photos)

"​For glabellar lines (or frown lines / ""11"" lines), we inject Botox, Xeomin, or Dysport into the muscle, causing the muscle to weaken and improving the appearance of the lines. These work by binding to receptors that send nerve signals for muscles to contract. Since your body makes new receptors and neurotransmitters all the time, it needs to be maintained otherwise the wrinkles will slowly return as the muscle regains function over time. Neurotoxins take 2 to 4 weeks to start working and lasts for up to 6 months.

For deeper glabella lines or strong 11s, I use a combination of Botox with fillers, lasers and microneedling with PRP. I suggest getting a formal evaluation with an experienced cosmetic dermatologist and expert in lasers and fillers. Best, Dr. Emer
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Without knowing the number of units of Botox that were injected in this area it is difficult to advise you. It is possible that additional Botox alone will reduce the 11's. A more permanent solution would be CO2 laser resurfacing, chemical peels or multiple microneedling treatments.

The frown lines, aka the 11’s, are caused by the strong pull of two muscles that sit above each eyebrow. If you are looking to soften these, the best thing to do is get Botox in this area. These muscles vary in the direction from which they pull, so it’s best to go to an experienced injector to assess your anatomy. The microneedling can be used to diminish  fine lines and greatly improve the quality of your skin- which is a factor contributing to  facial lines.   The more brittle your skin : the harsher the lines.  Gravitational lines, lines that persist when your face is at rest, tend to be deeper and are responsive to fillers.  Since you have many options, the first thing you should do is go to a professional who can assess exactly what you need. Hopefully this has helped! Good luck!
In Good Health,

Ellen Mahony MD   

Botox and other neuromodulators are great from taking away dynamic rhytides (wrinkles from moving).   Lines that are there at rest (static wrinkles) will improve with botox and will go away over time with continued use.  For patients with deeper lines, combinations of botox and filler or resurfacing treatment like laser or peels can improve results.  In your case, you appear to still have some muscle tone in the forehead muscles and probably need a higher dose prior to having microneedling or resurfacing treatments.  Best of luck.

Yes, combination treatments are best; starting from simple facials with microdermabrasions and light peels or lasers (to help resurface the skin and exfoliate dead skin cells) along with Botox treatments that will help wrinkles from worsening over time while smoothing existing fine lines out.  Topicals are also important to maintain moisture, protect from free radicals/sun damage (vitamin C, SPF, etc), as well as to encourage light exfoliation (Retinols). Hope this helps.

Thank you for your question. It is difficult to give you advice without knowing how many units of Botox you received. However, the frown lines (11’s) are very strong muscles and you may require additional Botox to soften the lines. I recommend addressing your concerns with your injector as he/she can make any necessary touch ups. Best of Luck!

Thanks for your question and the photos and we always recommend that you have a consultation with a board certified dermatologist or plastic surgeon to learn all of your treatment options. It would be helpful to know when you had your last Botox treatment and how much Botox was used in the areas injected.  Sometimes, more Botox is needed. Sometimes, the lines are too deep and in addition to Botox, an HA filler is indicated. The use of microneedling can help some, and after you have it done, you can see if further injectable products are needed.  Good luck.

Thank you for your question. Micro-needling on it's own will probably not have a significant effect. You may want to consider radio-frequency combined with micro-needling. We have had good results with the Endymed Intensif unit. Fillers would also be a reasonable next step.

Thank you for the question and posting your pics.  It would have been good to see the pictures from before the treatment.  You state you have had Botox twice but other important pieces of information would be what dose you received an how far apart the treatments were done.  Both of these will make a difference.  It's important to remember the neuromodulators don't fix those frown lines-they eliminate the cause and the frown lines heal themselves over time.  If they were very deep to start with it takes a longer time and you can definitely speed up the resolution of these with a little bit of filler into the frown lines but I only recommend doing that if you continue with the Botox.  I hope this helps.  All the best.

The vertical frown lines you see between your eyebrows (the 11's) are caused by chronic frowning leading to creases. Botox relaxes the frown muscles which will soften the creases but if they do not go completely away then adding a small amount of filler can assist in further improving these creases.  Microneedling can help the acne scarring but will not likely make much further improvement in the vertical frown lines.  Filler is your answer.