Can I get fillers on my 11 lines or should I try plastic surgery instead? (Photo)

Thank you for your question and photo. Keep in mind that neuromodulators require a great deal of precision and expertise in both needle placement and dosing amount to achieve an optimal outcome. It is possible your injectors have not been experienced enough to produce the best possible result. It is also possible you might need a bit of filler in addition to the neuromodulator if your 11s are permanently etched and a bit more stubborn. Find a very experienced, board-certified injector for your treatment and my guess is you will see a better result - no surgery needed.

"​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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Hi @DDH123! Neuromodulators like Dysport or Botox in combination with hyaluronic acid dermal fillers like Juvederm can be an effective treatment to smooth out the 11 lines. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of Luck, Dr. Nima!

Fillers can be used in the gabellar area if performed carefully and staying very superficial. You should have it done only by an experienced injector with detailed knowledge of the anatomy in that area as there have been reports of vision loss from injecting fillers in the gabella. You should also try having someone else inject Botox because your injector may not be hitting the muscle in the right place.

This area is considered very high risk and should only be done by a doctor who has sufficient experience in training for this area. Plastic surgeon or dermatologist is reasonable choice. Dermal fillers are the best choice to inject this particular area with botox.

Unfortunately, some patients may have excessively strong corrugator muscles requiring a significantly greater number of units to achieve the desired result. However, proper injection technique is also vital to a successful treatment, so you may want to consider another physician. The glabellar complex has very important vasculature running through the area, making fillers an unsafe option for treatment in this area in most cases. Energy based resurfacing devices are much safer alternatives. Remember to always consult with a board certified cosmetic physician.

I agree that the main issue in your case is likely not having had Botox injected by a highly trained and experienced physician injector (e.g. dermatologist) who can safely and effectively treat your 11s with Botox, and can safely (due to extensive knowledge of anatomy) inject filler into this otherwise "risky" area. A lot of things are "risky" if you're not properly trained or experienced.

I encourage you to visit with a board certified plastic surgeon near you for a consultation. If Botox is not effective in treating your glabella you may consider FaceTite. This procedure use RF technology to tighten skin up to 40%. The results are enhanced with Morpheus8 treatments which improve overall skin tone and texture.

I have a sneaky suspicion that you never had a plastic surgeon inject you with Botox. It’s not just a large amount of Botox that’s needed to correct your frown lines but a proper injection technique.

You don’t need plastic surgery for these simple lines., Try going to a plastic surgeon for Botox first. Fillers can also be injected in this area quite safely but again it is an experienced injector that should be doing this. I hope this helps and good luck from New York City Plastic Surgery an Patient

The 11" lines you have are more depressions than lines. These depressions should be controlled with Botox. The other thing that is needed is basic skin care plus tretinoin (Retin-A) and Obagi's ELASTIderm to stimulate collagen to thicken the skin and make it less likely to bend and to add elasticity to encourage contraction rather than bending. If, after receiving Botox by an expert, you still have significant muscle function, then surgical removal of the muscle causing the folds is possible as a simple in office procedure. If the muscle function is controlled but you still have the depressions, this is easily and safely corrected by an expert who understands the vascular anatomy of the area and how to elevate this area safely.