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
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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.

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 @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.