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Botox
What do I do when Botox is no longer taking care of my nasty 11?
If you find that Botox is not working as well, the next step might be to try one of the alternative neuromodulators such as Dysport or Jeuveau. Though these brands are essentially the same group of medication and mechanism of action, there are slight differences that may be more effective for you if you've only been using Botox for the past 10 years. You can also consider fillers to fill the lines but it's recommended to continue Botox/Dysport/Jeuveau at the same time to reduce muscle movement. Fillers in this area is particularly risky for vascular occlusion and blindness. Make sure to see an experienced provider to discuss to make an informed decision.
Clinical Context
The '11s' form from the corrugator and procerus muscles pulling brow skin together with frowning. Over years, repeated folding can etch a static line that remains visible even when muscles are relaxed, which is why neuromodulators alone may stop working as well over time. This area also carries vascular risk: the supratrochlear and supraorbital vessels run near the surface and connect to circulation supplying the eye, so filler here requires careful technique and an experienced injector.
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