Eleven wrinkles in seniors, are there advances in this area? (Photo)

First, I would suggest that you make certain you are consulting with an experienced, board certified cosmetic dermatologist. Droopy eyelids are certainly possible after Botox, but in my experience with using Botox in this region since 1991, it is quite uncommon. Furthermore, it appears that you have etched-in creases from years of muscular movement, and for this relying on Botox alone, which works on motion-related (dynamic) wrinkles is seldom sufficient to achieve gratifying results. The additional use of a less robust, cohesive HA filler can help to elevate and smooth the wrinkles at rest (static) wrinkles). What's more the combination of the treatments, which can be done in the same treatment session or in two separate sessions, has a synergistic beneficial effect that lasts longer than can be achieved by either treatment approach alone. So, take heart, and make sure you are seeing an experienced physician injector before throwing in the towel. Best of luck.

​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
​

Thank you for your question. If you have only used Botox to this point, trying a combination treatment with Botox and dermal fillers may be beneficial. Droopy eyelids can certainly be a side effect of Botox, so it is important to consult with an experienced, qualified injector who uses the appropriate amount and places it correctly to target the muscles. Hyaluronic acid (HA) fillers can help eliminate static wrinkles and target the glabellar furrow. An in-person consultation with an experienced and board-certified dermatologist can provide you with a personalized plan that determines which fillers will work best for your needs.

Hello @NSacto, thank you for your question. I suggest developing an improvement plan that takes all aspects into account after completing a comprehensive evaluation. The botox application should not cause a feeling of heaviness in the eyebrow, this is determined by the technique used. For more information and recommendations, it is prudent to consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS.

Botox is the gold standard to treat the area that concerns you. I encourage you to visit with an experienced injector for your treatment. You should not experience droopy lids from your treatment. You can also enhance your results by adding Morpheus8 treatments. They use RF technology combined with microneedling to improve overall skin tone and texture.

Hello, you are young and will benefit from Morpheus8, which is a microneedeling with radiofrequency technique that will regenerate collagen in you skin. Let me know if you have any questions.
Dr. P

A small amount of a dermal filler such as volbella injected in this area and low dose Botox should be very helpful without causing droopy eyelids,Experienced injector only

Thank you for your question. Botulinum toxin injections are designed to be preventative and will only keep the dynamic wrinkles or furrows from worsening. It would not help furrows that are present at rest. With regards to the neuromodulator injection "always make my eyelids a little droopy", that is more likely related to the injector's technique rather than an accepted "trade off". In my experience, when treating glabbelar furrows, its best to use the neuromodulator in a higher concentration in glabella and also treat the forehead and crow's feet along with a 1-2 unit injection just under the tail / lateral 1/3 of the brow to help lift the brow and open the eyes. I would recommend seeking an experienced dermatologist, plastic or facial plastic surgeon for your next treatment.

If Botox is placed correctly and with your history given to the provider, you should be able to avoid the dropping and help the 11 lines in the glabellar area. That being said and assuming you went to an experienced provider, using dermal fillers for these deeper lines in that area is a good adjunct procedure that you can obtain. It is a must this be done by a very experienced injector however as this is a higher risk areas for fillers given the blood supply in this area. I hope this helps.

Hello and thank you for your question. It is always best to see you face to face for a consult and examination however in this case if your frown was only to be treated it should not make you feel heavy. Heaviness is created by injecting in the forehead/frontalis muscle-In your case treating only the frown would help soften the area and also should lift your brows. I hope that helps answer your question. Always seek an experienced and qualified medical professional for these treatments. Very best wishes