Post Botox 11s Lines Still Slightly Appearing, How To Treat This?

My main issues to which I resorted to getting Botox was my glabella "11" lines. in my particular case, its really "1" since one muscle is predominantly stronger than the other. it took 35 units to finally get the area frozen. i am happy with the results however, i still see a "line" in the area. its not a deep wrinkle at all... it just looks like a shadow of where the line was is still there a bit. granted, when i grown, that mark is still there.any ideas how i can lighten that mark???

Doctor Answers 16

Botox for glabellar frown lines

It sounds like the muscle has been knocked out with the dose you received.  It will take many weeks or even months for the crease to smooth out and it is important to keep up with the Botox to keep those muscles knocked out or they will once again work on the overlying skin to reform the wrinkles.  It has been my experience that subsequent injections last longer and take less Botox.  I have some patients who come in only once a year now for maintenance.  Botox is like a lot of other things:  waxing (ouch), coloring your hair (stinky) or a pedicure (niccccccce).


Seattle Plastic Surgeon
5.0 out of 5 stars 73 reviews

Botox treatment of the glabellar forehead "11" frown line

If your Botox was only done in the last few days, you may get more muscle relaxation during two or more weeks after the treatment.  Therefore, you may see further improvement.  Some people have very deep lines because they have scrunched the skin together so many times over so many years that the lines stay etched in the skin for a while after the muscles do get relaxed from the Botox.  It may take several sessions of maintaining the Botox treatment so that the muscles never "wake up" and allow the skin to continue to not crease and let the lines fade away.  If there is a big social function coming up for which you want to look your best and can't afford the patience of time, then sometimes, a small amount of not-too-thick a filler can be used, such as Restylane or Juvederm in this area to fill out the line.  It doesn't mean that the filler would have to be repeated when it wears off in a year or so just as long as the Botox treatment is maintained every three to four months.  Injections of fillers in this area has a risk of circulation compromise and there have been reports of big scabs forming and even scar formation when very thick fillers or fillers injected with high volume were placed in the glabella so speak to your dermatologist or plastic surgeon about this prior to having the injections. The advantage ofusing Restylane or Juvederm in this area is that if there is a problem, the filler can be dissolved by injecting an enzyme, hyaluronidase.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Wait until a few more cycles of Botox to worry about this!

This is not uncommon. Some people get smooth on their first botox injection.  Others need to have their muscles get a little more "flabby" on their second or third round of injections (every four months regularly.)  Stick with this and don't wait six months to go back, or you will be starting over.  If after one year of botox there is still a little bit of a line then consider getting a filler in that area as well.  Be a patient patient!

Phillip C. Haeck, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 37 reviews

Residual line after Botox

It sounds like your Botox worked beautifully but you still have a bit of a fixed line.A little bit of filler (Restylane or Juvederm) should diminish this line for you. Many patients also have to use Botox and a filler in this area to get the correction you want. These do come in 1/2 cc syringes so that would help keep your costs down.

Esta Kronberg, MD
Houston Dermatologic Surgeon
4.9 out of 5 stars 30 reviews

Residual Line after Botox Injection

If the residual line you describe is present at rest (without forehead movement) Botox will have no effect on that crease. The easiest way to treat that line is the injection of a filler such as Radiesse , Restylane, or Juvederm. If there are lines of animation, you can use more Botox.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

How To Treat Lines That Appear Even After Botox

Botox is an injectable neurotoxin that improves lines (wrinkles) that are dynamic, meaning secondary to muscular movement.  Fillers improve lines (wrinkles) that are static, meaning visible at rest.  In the glabellar area (area between the eyebrows), it is always best to address the frown lines (11 lines, dynamic lines) first with Botox.  If there is still a trace of a line seen when frowning, you can try adding a little more botox; however, if the line is seen only at rest (static), then you can very conservatively fill that line with filler.  I recommend you return to the physician who did the botox treatment for evaluation and for possible further treatment. 

Channing R. Barnett, MD
New York Dermatologist
4.1 out of 5 stars 8 reviews

Post Botox 11s Lines Still Slightly Appearing, How To Treat This?

Either add a little more or use a filler like Restylane. Or both. Return to your chosen injector, I hope it was a doctor. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Frown lines that persist after Botox

The problem of a persistent line after adequate Botox is usually a result of  dermal atropthy from years of frowning.. Botox is effective for what we term dynamic  lines i.e. lines when the muscles below are contracting. Botox is left effective for static lines i.e. when the muscles are relaxed. For those cases its helpful to inject a filler such as Restylane or Juvederm. 

Ted Brezel, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

When to consider a filler in addition to Botox

Since the vertical lines between the eyebrows are caused mostly by hyperactivity of the underlying muscle, treatment with a relaxer like Botox or Dysport is the first step. However, if they have been there a long time then the lines become "etched" into the skin. So if you still see a line there after the Botox has taken effect, the next step is a dermal filler such as Juvederm, Restylane, or Radiesse.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 54 reviews

You injector needs to be super careful injecting the 11 area with filler.

Unfortunately the glabellar area where the 11 lines form is highly vascular.  Filler treatments in this area can cause local circulatory problems with necrosis of the skin.  Treatment in this area must be very superficial to stay out of the subdermal vascular plexus to avoid problems associated with putting filler into the circulation.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 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.