I'm worried that the Botox was not injected in the proper place for my "elevens"??

Two weeks ago I had 20 units of Botox to get rid of my "elevens", a procedure I've had done before with 2nd day results every time! I don't think this new Dr. injected the correct place. I went back because my "elevens" are still there!! He injected another 20 units. I took notice of the injection placement. He did NOT inject the muscles that push together to create the "elevens", instead, he put the Botox right onto the creases and slightly lower inbetween. I'm afraid this is not going to work AGAIN!?!?

Doctor Answers 15

Correct Muscles May Not Have Been Targeted With Botox for the "Elevens"

I’m sorry to hear that you were unhappy with your treatment. Since I was not there, I unfortunately cannot speak to where your physician injected the Botox. You are correct that the Botox needs to be injected into the muscles that cause the frowning movements, to help relax your forehead so that you cannot form the “elevens”. If you find the treatment does not work, it is possible that the Botox was not injected into the correct muscles.

Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Injecting "elevens" with Botox

I assure you that if your injector is a highly trained physician such as a dermatologist or plastic surgeon, that you received the injections in the right place. An injector really needs to assess the strength of the muscles and other factors, and know what depth and what amount to inject, so choose your injector wisely otherwise you'll get suboptimal results and potential side effects. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.8 out of 5 stars 53 reviews

Botox Works Well For The "Eleven" Lines (Scowl Lines, Frown Lines) In Experienced Hands

I have been injecting Botox for aesthetic reasons, since 1991, which means that I have been treating the so-called "eleven" lines for twenty-three years, as this was the first location for its cosmetic use. In that time, I have consistently found Botox to begin working anywhere from between the following day and one week later (and rarely as long as two to three weeks later)--a time frame that usually remains pretty much about the same from treatment to treatment. Twenty units properly injected within the bodies of the appropriate muscles of the region typically do the trick. (Injecting the creases between the muscles would be far more appropriate for injecting hyaluronic acid products to treat the static wrinkles that result from years of dynamic contraction of those muscles.)

Some additional thoughts: I have observed a very small number of individuals who seemed to have developed a relative resistance to Botox after several prior successful treatments. In other words, someone who has done well in previous treatments may find that they require more Botox to achieve the same results, or even need to be switched to another neuromodulator, such as Dysport or Xeomin to achieve those results. The presumed explanation, although not proven by any means, is the possible development of antibodies to the Botox. One recommended way to avoid this is to perform touch-ups no sooner than one month after treatment, rather than the two week interval usually recommended. The bottom line: seek treatment by a board certified core aesthetic physician with extensive experience in injecting neuromodulators.


Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 30 reviews

The same treatment tends to work the same way every time it's used...

but certainly it's typical for botox to take several weeks to produce optimal results...all than aside, the botox must be injected relatively close to the correct points to provide the desired cosmetic effect...don't think you should go to the same doctor for treatment if with 40 units into the glabella (11s) you're not seeing results after allowing at least 10-14 days to pass...see a dermatologist or p. surgeon for best results or check with a doctor on Realself in your city

Ken Landow, MD
Las Vegas Dermatologist
4.6 out of 5 stars 9 reviews

Botox injected in the "elevens"

There are various techniques for injecting Botox. However, the best way to tell if it was done correctly will be by your result. If you can still frown after 20 more units, something may be wrong.

Jeffrey W. Hall, MD
Austin Plastic Surgeon
4.5 out of 5 stars 19 reviews

Botox placement

Correct Botox placement requires experience.  If you had 40 units in the glabella area and still do not have the desired results I suggest you consult a board certified dermatologist with a lot of experience with Botox for the best cosmetic results.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 78 reviews

Anti-Wrinkle Treatments in the 11s

Hi there,

The treatment you received into your glabellar (11s) area should be enough to smooth out the wrinkles in this area. They should have at the very least been reduced significantly.

There could be a number of reasons why you have not achieved the same effect, the most likely, as you have alluded to is that the injection has not quite been in the right position.

I'm interested as to why you changed  doctors. If you were getting a good result after 2 days previously I would stay stick with what works!!!!

Best wishes

Richard Bloom

Richard Bloom, MBBS (Hons), FRACS
Melbourne Plastic Surgeon
5.0 out of 5 stars 119 reviews

I'm worried that the Botox was not injected in the proper place for my "elevens"??

If your wrinkles are very deep to start, it may require a few rounds of Botox to smooth out the lines, I suggest being patient and waiting at least 10 days before re-injecting the area 

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Botox in the elevens

I tell my patients to give their Botox two weeks before adding more although results are usually visible at 5-7 days. It seems that enough should have been injected to at least weaken muscle movement. Even with complete elimination of movement "lines" can still be present . When this happens we use a small amount of a soft filler. First you must determine if muscles move. If they do, you need Botox done again and maybe consider discussing why this might not have worked with your doctor before changing if this is someone that has served you well before. 

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 19 reviews

Good Advice by other doctors

Drs Saini and Kraft have given very good advice and I second all of it.  Be patient.  Seek PHYSICIAN injectors that are dermatologists or plastic surgeons.    You will be fine.  Also when you find the right doctor stick with him or her.  My Best,  Dr C

George Commons, MD
Palo Alto Plastic Surgeon
4.5 out of 5 stars 36 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.