11's just won't go away? (Photo)

Question

I posted earlier about my stubborn 11's/little excess skin. I had a total of 38 units (18 first round and over a month later another 20 units). I can still move my eyebrows. What is wrong here?!?!?

Christopher Balgobin, MD · Answer

Hello,Wrinkles took years to form. Sometimes it will take several rounds of botox to get those lines to disappear. If you still have movement, you may want to try Dysport or seek another injector.

Frank P. Albino, MD · Answer

Botox is a great tool for dynamic wrinkles or those that you see with movement.  Once these are treated, however, the "static" lines or those at rest will not respond to treatment with additional Botox. You may be a candidate for filler, chemical peel, or skin care to minimize these "static" fine lines/wrinkles. 
Not everyone is a good candidate for this treatment so please see a Board Certified or Board Eligible Plastic Surgeon to evaluate if you may benefit. Good luck!
This content is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare professional.  You should always seek the advice of your physician or healthcare professional for any questions you have about your own medical condition.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.   There is a very wide range of sensitivity to Botox and the neuromodulators among the general population with some patients simply needing more than others.  You can continue to increase the dosing to see if this improves your results or you can try another product to see if it works better on your muscle activation.  Be sure you are also seeing a board certified plastic surgeon for treatment.

Damon B. Chandler, MD · Answer

The 11 lines (glabellar lines) can be stubborn and challenging to treat. As others have mentioned, you either need a new injector/technique or perhaps some filler. Please have a second opinion in person with a board-certified, fellowship trained Oculofacial Plastic Surgeon or other doctor who specializes in cosmetic facial injections and facial plastic surgery. Avoid non-doctors, nurses, "specials," and choosing the providers with the lowest prices -- that way you give yourself the best chance to see an expert. Best of luck in your search.
Damon B. Chandler, MD
Harvard-Penn Trained Oculofacial Plastic Surgeon

Michele S. Green, MD · Answer

If your glabella lines are deep then simply adding more Botox if there is no more movement in that area won't help.  You may need more filler to help correct this area and that has to be done carefully.  Please consult an expert in Botox and cosmetic fillers for the best results.  Best, Dr. Green

Mark Lupin, MD · Answer

When number 11's are present at rest, fillers are required for the majority of patients if you want to properly address these lines.  Botox is important as it is treating the reason for the lines and naturally should be optimized and maintained.  Having no movement does not necessarily erase lines, does not necessarily look natural, and does not usually provide long lasting improvement to static lines.  Some of the happiest patients are those who see that filler can immediately improve these lines.  And often, filler will extend the time between Botox treatments.  If you treat number 11 lines early on, Botox alone may be sufficient.  They just require addition of filler when they have been more deeply ingrained and are noticeable even when you are relaxed.  Hyaluronic acid fillers are the normal type of fillers used for this purpose.

Jo Herzog, MD · Answer

Thanks for posting as brings up important points. There is a huge difference between someone saying they still have 11's and saying they can still move and make glabellar area crease. If you can't move, but have crease, you will get no benefit from more toxin, you need filler. If you can move then two things possible. You might need more toxin because you can still move the muscles that were treated or you might be squeezing hard and recruiting other muscles to do this. If you are recruiting muscles you are probably testing in mirror and not likely to do this as part of your regular expression. If that is case, stop looking. If you are moving easily with regular expression, go back to your doctor and see what they think

Beata Danek, MD · Answer

You already have permanent deep frown lines and more Botox will not make it any better - it only works for "dynamic wrinkles" (moving), and not "static" ( not moving). You need Juvederm filler -it will definitely make you happier and will last about 12 months.

Steven Wallach, MD · Answer

Sometimes other muscles are recruited to affect the muscles. It definitely looks softened.  Perhaps you need a little filler as well.

Oren Paul Mushin, MD · Answer

Hi there, so there are several reasons why you could be experiencing these issues. First of all, there is a chance that botox may not be effective in you, though it is very unlikely. Trying another neurotoxin may be helpful in that case. More likely, however, the botox might be working but the lines you have may be recalcitrant to the treatment. This means you may need an adjunct such as fillers to soften the lines. The fact that you can move your eyebrows doesn't necessarily mean that the botox isn't working, as there are several muscles that move the brow. I suspect in your case multimodal treatment of the area may be required. Be sure to visit an experienced practitioner who can help sort out these issues.

11's just won't go away? (Photo)

Answers (13)

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