11's returning after brow lift?

I had a brow lift approx two months ago and my plastic surgeon said I would no longer have to get Botox for my 11's as he did something to a muscle that would make that issue a non issue I am pleased w the new placement of my brow and for about six weeks I did not have the 11 wrinkles between my eyes which before were quite deep however in the last two weeks they r returning and not just slightly . Why would this be happening if he severed something that allowed me to move that muscle set?

Doctor Answers 5

Botox Best For "Eleven Lines"

Treating the scowl lines (frown lines, eleven lines) between the eyebrows was the first and remains one of the most consistently successful and gratigying aesthetic uses of Botox (as well as more recently Dysport and Xeomin). Surgery and other aggressive and more invasive techniques for severing or freezing muscles have not in my experience proven quite as reliable, as your story illustrates. The likelihood here is that you will continue to need Botox for your eleven lines, but in lesser amounts. For others reading this answer, it should serve as a caution against exaggerated claims for the permanence of more expensive, aggressive and invasive ways of treating this important cosmetic unit. 


New York Dermatologic Surgeon
4.8 out of 5 stars 24 reviews

Brow lift: muscle modification and 11s afterward

Browlift is a procedure to improve the position of the eyebrows. This can be performed by many different approaches. Muscle modification is a technique to remove muscle fibers from the depressor muscles for fewer wrinkles. Some surgeons even put a piece of fat in between the cut ends of muscles to ensure a separation. Even with good and safe technique, these muscle fibers may remain or they can pull on the scar. The pull will be less, but never completely gone.  I find Botox to be more effective for controlling the 11s. Safety comes first. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Weakening of the glabella muscles during brow lift

During the endoscopic brow lift procedure, the corrugator and procerus muscles that cause the 11s are typically ablated by direct excision/division of the muscle fibers.  I usually tell my patients that the 11s will be weakened and should lower their botox requirement in the glabella in the future, but I do not guarantee permanent paralysis of the muscles.  This is because it's impossible, and more importantly, not safe to remove every single muscle fiber and the muscle fibers may "grow back" together despite surgical ablation.  Hope that helps.


Goretti H. Taghva MD

Goretti Ho Taghva, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 48 reviews

11's returning after surgery and a treatment for them.

Sorry to hear they are bothering you again.  I am unaware of any surgery that will completely and/or permanently eliminate these muscles from contracting.  I do surgeries to lessen the 11's (corrugator removal), but it is hard to get every fiber without causing sensory nerve loss and/or an abnormal appearance.  I doubt that your 11's will be as prominent as before your surgery.  I tell most of my patients that they usually get a 50% or slightly better improvement with them and that wrinkle blockers (botox) can still be used, but often not as much is needed and it lasts longer.  I would speak with your surgeon about your concerns.  Best regards.

John R. Burroughs, MD
Colorado Springs Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews

Brow Lift

Thank you for your question. Please post before and after photos. A brow lift is intended to reposition the brow shifting the wrinkles and repositioning a sagging brow. Botox can be an effective approach to removing 11's. In addition to posting pictures here, I suggest that you follow-up with your surgeon to learn more about what you are experiencing. 

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 97 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.