40 y/o - Botox, filler, or laser for (really) angry 11s? (Photo)

Thank you for your question in regards to Botox.From your picture and your description of what your goals are, filler will not be necessary. Botox is a perfect place to start. Be sure to discuss with the injector what your specific goals are. A minimal amount of Botox ma be added for the first time. After two weeks, follow up with the injector. At that time, you may love it or may want a few additional units. To be sure what is best for you, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment.I hope this helps.

I like to start with the most conservative treatment I can, soI would recommend using Botox as the first line of treatment.  The 11's are caused by muscles flexing your skin so the Botox will paralyze those muscles so the skin can't be flexed.  Without continued flexing of the skin the 11's should get better.  If the 11's don't resolve to your satisfaction a filling agent could be added to fill in the depressions.  I don't start with a filler as the first line of treatment because if the muscles causing the problem are still active, the muscles will still crease the skin even with the filler in.  Laser treatments are not likely to do anything.

Thanks for the question, its a complicated one but perhaps this may help. I inserted a link below to a news story on Good Morning America in which I was featured. It discusses some of my research into wrinkle reduction with Botox. Also, if you look on my blog (the link) you will find an article I wrote discussing the difference and effects of Botox versus fillers. I have a feeling you will find this helpful,Dr James P. Bonaparte
Facial
Cosmetic and Reconstructive Surgery
Ottawa,
Ontario, Canada

Hello, Botox would be my first choice as it is generally safe, minimally invasive, and very effective. I would not pursue fillers or a Laser treatment to help with this. I recommend you see a board certified Plastic Surgeon. Good Luck.

I suggest seeing a cosmetic dermatologist there is a combination of treatments that can be done for "11" lines.  See someone experienced for a subtle natural look.  Best, Dr. Emer.

Thank you for your question and for sharing your photograph.  You look to be an ideal candidate for one of the available wrinkle relaxers - Botox, Dysport, or Xeomin.  Wrinkle relaxers are safe, predictable, and minimally invasive procedures that will effectively resolve your angry 11's.  See an ASPS board certified plastic surgeon for an in-person evaluation and treatment.

Thank you for your question regarding the deep 11's on your brow that are bothering you.  Botox could be a very good solution for you.  If this is your main concern, you should not need any other fillers at this time.  You do not have to be concerned about a frozen face. Results with Botox are subtle yet significant.  It is reassuring to know that if you are not happy with the result of Botox injections, that they are not long-lasting.  Most patients actually wish that their injections lasted for a little longer than the 3-4 months that is typical. A laser won't address this issue.Best of luck to you.   

The "11's" or pair vertical lines in between the eyebrows ( medical term: medical galbella wrinkles) are secondary to the contraction of the muscles that bring the eyebrows together ( the corrugator muscles). These  11's  wrinkles most of the time can corrected with the use of Botox, a cosmetic medication that weakens the muscles involved in the wrinkles.Sometimes the 11's are could be also secondary to skin breakdown  in between the eyebrows(cracks in the skin). In these cases, Botox will smith those lines but won't make them disappear.Patients with "11's" wrinkles looking to treat them for first time should start with Botox treatment first. If the cracks in the skin are evident, they could treat with dermal fillers like belotero at the same time. Laser skin resurfacing could be also done, after Botox treatment, but that involves downtime recovery usually not seeing with Botox and fillers

Botox is definitely the best option for you. The goal would be to reduce the movement of the muscles that make this expression but not eliminate the movement completely since you are seeking a more natural look. In addition to looking better now, regular Botox treatments will prevent the deeper facial lines and wrinkles often see as people get older.

Lines and wrinkles are due to multiple causes.First involve the muscle action causing the line.The second involves the sun damage in the skin in this area.This is the difference between dynamic wrinkles ( due to muscle action) and static wrinkles (due to sun damage).The best and safe option is to have botox 1st to reduce the dynamic component. Then in 3 weeks after if a line is still present in the skin, this would be the static component and would best be addressed by techniques to improve the skin such as microneedling, or the very careful use of filler in this area.There have been cases of blindness with filler in the 11 area but not with botox there.I hope this was helpful.