Is Botox the best for frown lines (number 11 lines)?

These number 11 lines make me look tired all of the time and I'm sick of people telling me to smile more and be more radiant. Creams definitely don't work so my last solution is an injectable. After rigorous research, I've discovered that Botox is the most recommended drug for frown lines, but I know Botox is permanent. I'm a bit scared to try something permanent as my first cosmetic treatment ever. I don't know. Maybe I'm just paranoid. What other solutions are there?


F, 43, Utah

Number 11 frown lines are caused by the repeated contraction of a pair of facial muscles known as the corrugator muscles. You activate these muscles when you squint, frown, laugh, and make other facial expressions. Over time, this can lead to the development of frown lines which may be present even when you’re not frowning.

You have a few different options for treating these frown lines. Contrary to what you’ve heard, botulinum toxin (otherwise known as Botox) injections are not permanent — the typical duration is roughly four or five months.

Botox injections work by blocking the nerve impulse involved in the contraction of the corrugator muscles. Decreasing this muscle activity allows the overlying skin to relax, which helps to reduce wrinkles and smooth out the skin.

In addition, Botox treatment is FDA-approved, generally considered to be a very safe treatment, and has a rich history of use across the United States and around the world. This makes it a good option for cosmetic patients such as yourself who are, understandably, concerned about safety and potential side effects.

Many plastic surgeons will recommend Botox injections as the first step for treating frown lines. However, there are a few other viable options you might want to consider. Temporary dermal fillers, for example, can be used on their own or in conjunction with Botox to add facial volume, reduce wrinkles and fine lines, and create a more youthful aesthetic.

If you’re interested in a less invasive approach, you could also consider microneedling, a cosmetic procedure that uses tiny needles to stimulate your body’s natural collagen production. There are also treatments that use ultrasound technology to promote collagen production and tighten up the skin in the targeted area.

Ultimately, the best way to treat frown lines depends on your desired aesthetic and unique anatomy. I recommend booking a consultation with an experienced board-certified plastic surgeon to discuss which type of cosmetic surgery will best address your concerns.

Hi MaryEJen:

Botox is usually the first line for treating the 11 lines.  If these are present when you are not animating then you may need a filler.  My favorite filler is fat because it has a permanent effect.

Dr. Ken Stein