Neurotoxin resistance - what else can I do to lessen forehead and 11 line wrinkles?

Question

I know it is rare, but I have developed antibodies to neurotoxins. It started with just a lessened effect 2 years ago, and at this point I’ve tried Botox, Dysport, and Xeomin multiple times with different providers with no effect whatsoever. My question is- what else can I do to lessen forehead and 11 line wrinkles? I’ve read thermirase, but seems very hard to find an experienced provider around me I’m in Nashville). Any thoughts on treatments that would minimize movement and wrinkle lines?

Nelson Lee Novick, MD · Answer

I have been treating horizontal forehead worry lines and glabella eleven lines for several decades with gratifying results using a properly injected cohesive, less robust HA filler, such as Belotero Balance. While the use of Botox (and the other neuromodulators) in these regions treats the underlying muscles that contribute to the development of these lines, the filler addresses (by elevating and smoothing) the etched-in creases that have already formed as a result of the aforementioned muscular activity. Ideally, both Botox and filler are used for best result and act synergistically with prolonged benefit. However, in this case, typically gratifying results (when an experienced injector performs them) can still be expected from the use of the filler alone. Make sure to consult with an experienced, board certified cosmetic dermatologistj, since filler treatment of both the glabella area and the forehead should not be left to the hands  of a novice injector. Best of luck.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Camille Cash, MD · Answer

Keeping your skin healthy will help to improve fine lines and wrinkles, but will not lessen movement the way neuromodulators do.  You can consider Morpheus8 which uses RF technology combined with microneedling to improve overall skin tone and texture.  Regular peels designed for your skin concerns are a great idea.  We also recommend using medical grade skin care products such as Transform MD and wearing sunscreen every day.  A great place to begin is a visit to an experienced esthetician at a medical spa for a skin analysis.

Atlanta Innovative Medicine · Answer

One option that doesn’t require the use of neurotoxins and that has shown excellent results for treating both fine lines and wrinkles in the forehead area is PRP therapy, particularly a Vampire PRP treatment. There are two different treatments here: the Vampire facial, which involves a combination of microneedling and topical PRP, and the Vampire facelift, which involves a combination of subdermal PRP and hyaluronic acid injections. By combining the regenerative strength of PRP with the healing qualities of microneedling and hyaluronic acid, these treatments can be highly effective for treating all sorts of issues. 
We typically recommend the facial for achieving smoother looking skin, improving coloration, and treating texture issues, like forehead wrinkles and 11 lines, while we usually recommend the facelift for restoring volume and reshaping the face. That said, depending on the severity of wrinkles and your complete set of goals, either of these PRP therapies, or a combined approach, could be a great choice for treating your forehead. We hope this helps! You can learn all about PRP and other therapies for treating forehead wrinkles on our website:

Begin Anew Med Spa · Answer

Neuromodulators work on the muscles of the face; If this is not a viable option for you, there are other treatment options that work on building collagen that can address textural concerns of the face, including fine lines and wrinkles. One example of this, is Morpheus8, which is a radiofrequency micro needling device. This can be a great option for you that does not work on the muscles of the face but works by stimulating the production of collagen in order to restore volume to your face and soften those 'angry 11's' and forehead lines.

Neurotoxin resistance - what else can I do to lessen forehead and 11 line wrinkles?

Answers (6)

Answer: Revitalizing the Forehead: PRP Therapy and Vampire Treatments for Wrinkle Reduction

Answer: Revitalizing the Forehead: PRP Therapy and Vampire Treatments for Wrinkle Reduction

Answer: Forehead wrinkles and Angry 11's

Answer: Forehead wrinkles and Angry 11's

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Neurotoxin resistance - what else can I do to lessen forehead and 11 line wrinkles?

Answers (6)

Answer: Revitalizing the Forehead: PRP Therapy and Vampire Treatments for Wrinkle Reduction

Answer: Revitalizing the Forehead: PRP Therapy and Vampire Treatments for Wrinkle Reduction

Answer: Forehead wrinkles and Angry 11's

Answer: Forehead wrinkles and Angry 11's

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Recommended reading

Everything you need to know about Xeomin

Our mission is to create a world where every investment in modern beauty is Worth It.