Which injectable procedure should I get for my 11s? (Photo)

I am turning 37 in 2 weeks and I finally want to take care of these lines! I want to get the best results with minimal healing time so I cam go back to work on a Monday without looking weird.

Doctor Answers 20

For the number 11s, there are injectables to lessen muscle activity, and also ones to improve volume and skin quality

Thank you for your question. I understand that you’d like to have something done about your number 11s, and in a way that will not be obvious when you return to work on Monday. I can certainly give you some information with regard to how we approach patients like yourself in my practice. I’m a Board-certified cosmetic surgeon, and a Fellowship-trained oculofacial plastic surgeon, and I’ve been practicing in Manhattan and Long Island for over 20 years.

As you may be aware, the number 11s—also referred to as the glabella or glabellar lines—manifests due to the constant activity of two sets of muscles called the corrugator and the procerus muscle. These are the muscles that engage whenever you furrow your brows when you’re angry, thinking, or concentrating on something, so these muscles get a lot of activity.

Now, back in the 90s, the specialty of oculofacial plastic surgery was one of the first specialties to use Botox to treat benign essential blepharospasm, which is a condition where the eyes are involuntarily and forcibly closed. The corrugator and procerus muscles were very active in these cases. With treatment, it was noticed that with repeat injections, the lines became less deep.

In your case, if you do Botox or Dysport (which are neurotoxins and help relax the muscles), you can certainly go back to work on a Monday without any problems if you have it done on a Friday. At the very least, you’ll be left with only a pinpoint bruise. However, if you consider the long-term result, you may not see a full correction right away.

Keep in mind that it usually takes about 3 days for the muscles to relax, and then 2 more weeks for the peak effect of the Botox. The lines will be less deep, but it won’t mean that they’re gone. If you do this treatment every 3-6 months over the course of 1-2 years, then you'll see really significant improvement because those muscles are no longer continuously contracting.

For patients with deeply creased skin, or deeper facial lines, volume correction is suggested, because when there is an increased indentation in the skin, that means there is a collapse of foundation made up of collagen. We use a hyaluronic acid filler such as Restylane, which we combine with platelet-rich plasma, a material derived from your own blood. This combination adds volume and stimulates collagen growth and blood supply into the injection sites. Keep in mind, however, that the glabella is a sensitive region so it’s important to treat this area every carefully as there have been reported incidents of vascular compromise with injectables.

I hope that was helpful and I wish you the best of luck!

This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.


New York Oculoplastic Surgeon
4.3 out of 5 stars 61 reviews

BOTOX a Classic for 11s

Thanks for your question – it's one I hear a lot. What you call 11s, we doctors call glabellar lines, and the gold standard for treatment is BOTOX Cosmetic. The vertical lines between your eyes are caused by frowning, and frowning is controlled by tiny facial muscles. BOTOX is injected into those tiny muscles, temporarily relaxing them, which in turn releases the tension on the skin that is producing the lines. A skilled BOTOX injector can also soften your crow's feet, smooth horizontal forehead lines, and even give a subtle lift to the brows with BOTOX. Results from BOTOX injections typically last 3 to 4 months. And don't worry about "looking weird!" If you go to a skilled, reputable injector, you should see a softening of lines without any impairment of your normal, natural expressions.

Be sure that you schedule your injections 7 to 10 days before your birthday party or other big event. It takes about that long for your results to emerge. Best of luck, and happy birthday!

Otto Weiglein, FRCSC
Burlington Plastic Surgeon
5.0 out of 5 stars 4 reviews

Botox

Botox will relax your 11s, and smooth out the lines considerably. If the lines are more deeply etched, you may consider adding filler directly in the lines at the same time.

Ava Shamban, MD
Santa Monica Dermatologic Surgeon
3.9 out of 5 stars 9 reviews

Lines

Botulinum toxin injections (Botox, Xeomin, Dysport) are safe and extremely effective options for these "dynamic" lines (occur due to repetitive muscle action). These should be strongly considered as a starting point and need to be repeated every 3 to 4 months. You may notice the lines gradually fading over that time. It is possible that the lines will not completely resolve. In this case, addition of certain fillers (Belotero, Restylane) can be helpful to fill in the remaining wrinkle.

Most importantly, please see an injector with significant experience in treating in this area with the products discussed and who has proven results.

Kenneth E. Morgenstern, MD
Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Which injectable procedure should I get for my 11s?

Botox Cosmetic® or Xeomin® can easily minimize frown lines/wrinkles. It is the most common aesthetic medical procedure performed, and requires no recovery time, if performed by an experience board-certified aesthetic physician. 

Manjula Jegasothy, MD
Miami Dermatologist
5.0 out of 5 stars 8 reviews

Treatment for the 11s

Hello leolionNJ,

I would recommend a combination of treatments.  The first is to get at the root cause of the 11s.  This is best treated with a neuromodulator such as Botox.  This will help to prevent these lines from worsening and can soften them. If the lines remain then the second recommendation is some material to fill in that area such as Juvederm.  You do need to be more careful with filler injections in this area as there is a risk of losing skin if too much is injected.  Make sure you find an experienced injector to minimize this risk and it may take several treatments to get the result you want (instead of a large volume at once because that increases the risk of skin loss).  The biggest risk of either treatment is bruising which may affect your look on Monday. Otherwise the risks are fairly minimal.  They should be discussed with your injector after a complete history is obtained regarding any medical issues you may have. 

I hope this helps and good luck.

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Botox For Dynamic Wrinkles; Filler For Static Wrinkles

In general, wrinkles have two contributing components to their development and progression: a dynamic component, meaning wrinkling that stands out with motion of the muscles of facial expression, and a static component, i.e. wrinkles that remains visible even at rest--"etched-in expression lines" (resulting from many years of emoting).

In the early stages of wrinkle development, such as in your case with the eleven lines at only 37 years of age, suppressing the hypermobility of the glabella area muscles with a neuromodulator (such as Botox, Dysport, and Xeomin) is usually all that is needed to achieve a significant improvement. At later stages, after etched-in lines have formed, the subsequent addition of a filler may be needed.

I have been injecting Botox for eleven lines (its original, first aesthetic use) for nearly a quarter of a century and glabella static lines for well over three decades, since the early days of its treatment with the original Zyderm I collagen filler. Both procedures, even if needed to be performed during the same treatment session, typically engender little downtime. Make sure to consult with a board certified aesthetic physician with experience and expertise in the use of neuromodulators and injectable fillers. Also ask to see his/her before and after photos.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 23 reviews

Which injectable procedure should I get for my 11s?

Botox/Xeomin/Dysport will work great for the 11s.  See an experienced injector for best results.  My patients typically go back to work or lunch following the injection.  I just ask my patients not to exercise for a day following the injection!  Good luck.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Treating 11's / frown lines

Botox is the best starting point for treating these dynamic/movement wrinkles. If the lines are etched in even at rest, then you may need to add a filler, but try the Botox first on its own and have your dermatologist assess the results 2 weeks later to see if filler needed, or possibly a higher dose of Botox. Very safe and effective and natural looking treatment when done properly.

Benjamin Barankin, MD
Toronto Dermatologic Surgeon
4.9 out of 5 stars 44 reviews

Botox or Dysport

Botox or Dysport is a very effective treatment for the "11s".  This treatment works to "freeze" the muscles that cause the "11s" and will minimize lines you have with movement.  Results take up to 2 weeks to be fully apparent and last around 3 months.  Side effects are rare, but you may have minimal bruising.  If the Botox or Dysport is not enough to minimize the appearance of these lines, you can add a filler such as Restylane.  Restylane is only needed if the lines are very deep at rest.  Consult with an experienced provider who can develop a personalized treatment plan to help you meet your goals.  Best of luck!

Kent V. Hasen, MD
Naples Plastic Surgeon
4.8 out of 5 stars 58 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.