Will laser resurfacing help eliminate 11 lines?

Question

I won’t do Botox or Dysport since I had a bad reaction to it before. I know using fillers in between eyes is dangerous. What options do I have? Could laser resurfacing eliminate those kind of deep 11 lines? Which laser would be best?

Harold J. Kaplan, MD · Answer

Hello 3502.  We would be interested in understanding what kind of reaction you had to Botox or Dysport since we have only seen an allergic type reaction 1 or 2 times in over 15 years.  We use filler between the eyes and this is not more risky than many other areas of the face and aspirating the needle helps to ensure we are not in a blood vessel.  If neither Botox (Dysport) or filler is not an option, then we offer laser resurfacing.  In some cases patients require all three to get an excellent outcome.  Dysport relaxes the muscle, filler lifts the deep crease and laser resurfacing "buffs" or "sands" away etched in wrinkles.  All of these options have their own place in the process and trying to use just one if you have very deep etched in 11 lines just won't work.

Michael I. Echavez, MD · Answer

Laser resurfacing can help improve "11" lines if they are fairly superficial.  If the lines are really furrows that are deep set, then laser resurfacing will not help with them.  Other than Botox or fillers, surgery can sometimes be done to improve frown furrows.

William Groff, DO · Answer

Thank you for your question and I’m sorry you have not had a positive experience with neuromodulators in the past. This is really the best treatment for frown lines between the eyebrows, as this is the only procedure that targets the muscles that cause the wrinkles to form. I would discuss your concerns with a board-certified dermatologist who has expertise in injectable treatments to determine why you had a reaction in the past and if it could be avoided moving forward. 
If Botox is not an option, you can have fillers in this area if they are administered by a very experienced doctor. There are additional risks to treating this area, but a qualified provider will know how to reduce them. Laser resurfacing is also an option, but it is doubtful this procedure would offer long-lasting results.

Francis Johns, MD · Answer

Thank you for your question.Resurfacing will help to remove the deep lines. But over time they will return because you are not doing anything to prevent the muscle from moving to re-create the lines.

Andrew Campbell, MD · Answer

Laser resurfacing with an Erbium laser or CO2 laser can definitely improve the 11 lines. However, those lines will return rather quickly due to the fact that the muscle that is creating them has not been addressed. Botox would be the most common way to treat the corrugator muscles that create the 11, but if that is not an option, an endoscopic browlift may be a good solution for you. During the surgery the corrugator and procerus muscles are partially resected which is like getting a little Botox there for the rest of your life. Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa

Jason Emer, MD · Answer

For glabellar lines (or frown lines / "11" lines), we inject Botox into the muscle, causing the muscle to weaken and improving the appearance of the lines. Botox works 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. Botox takes 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

Susan Van Dyke, MD · Answer

Usually the first thing to do with the 11's is Botox or a similar neuromodulator because they reduce the movement the is the cause of the problem. If the lines are etched in, deep and longstanding, then reducing the movement may not be enough. Fillers (in expert hands) are very effective to fill in the deep glabellar lines, but Botox (or similar) is still needed to reduce the cause (the movement).Some patients prefer not to have injectables like Botox and fillers. What is the option for them?  Resurfacing can be helpful to soften or lighten the lines but if they are deep, it is doubtful that they will be eliminated.Combination treatments are always the best approach but there is value even if only one treatment is an option.

Seth Kates, MD · Answer

Hi and thanks for the question.  Although possible, it is very uncommon to get a bad reaction to Botox or Dysport in the frown area.  Assuming that is the case I would strongly consider using a little filler to the area.  Done by an experienced injector it is not a dangerous procedure and it usually improves the area considerably.  Laser resurfacing is a big deal and it might be "too much punishment for the crime" to treat the frown lines.  Good luck

Will laser resurfacing help eliminate 11 lines?

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