Best Filler For 11 Lines: Solutions for Deep Glabellar Creases

Medically Reviewed
Medically Reviewed by Dr. Aurora Kalmanson on
Written by Fillers Editorial Team, plastic surgery specialists.

Glabellar lines, commonly known as “11 lines,” are a hallmark of facial aging, appearing between the eyebrows as a result of repetitive frowning and expression. While Botox is the go-to treatment for relaxing the muscles that cause these lines, it may not always suffice, especially for deeply etched lines.

In such cases, dermal fillers like Restylane, Juvederm, or Belotero can be used to smooth out the remaining creases. This article delves into the nature of glabellar lines, the use of Botox and fillers as treatments, and the nuances of using these methods safely and effectively to achieve a natural, rejuvenated appearance.

Botox as a Primary Treatment

Botox is widely recognized as the primary defense against the formation and deepening of glabellar lines. By temporarily paralyzing the muscles responsible for frowning, Botox can prevent the lines from forming or reduce their appearance.

Preventative Botox in the 30s and 40s

Starting Botox treatments in the 30s and 40s can serve as a preventative measure against the deepening of glabellar lines. By restricting muscle movement early on, these lines may never fully develop, allowing for a smoother appearance as one ages. However, if lines have already formed, Botox can still soften their appearance. It’s important to note that while Botox can significantly reduce the visibility of these lines, it may not completely smooth out deeply etched creases, which is where fillers can play a complementary role.

Botox Dosage, Duration, and Limitations

The effectiveness of Botox for treating glabellar lines depends on the correct dosage and frequency of treatment. Typically, Botox effects last about 3-4 months, with the muscle gradually regaining movement over time. To maintain results, regular follow-up treatments are necessary. It’s crucial to consult with an experienced provider to determine the appropriate dosage, as too little may not yield the desired results, and too much can lead to an unnatural appearance. While Botox is effective in reducing muscle activity, it may not be sufficient for deep lines that have become ingrained over time, and that’s where dermal fillers come into play.

The Role of Fillers When Botox is Insufficient

When Botox alone cannot fully address deep glabellar lines, dermal fillers offer a supplementary solution. These fillers can plump and smooth the skin where creases remain, providing a more youthful and rested appearance.

Types of Fillers for 11 Lines

Restylane: Restylane is a hyaluronic acid-based filler that is commonly used to treat moderate to severe facial wrinkles and folds, including the glabellar lines. Its smooth consistency allows for a natural-looking fill, which can be particularly effective for those with less pronounced 11 lines or for individuals seeking subtle enhancements. The results from Restylane typically last around six to nine months, depending on the individual’s metabolism and lifestyle factors. As with all fillers, the skill of the injector plays a crucial role in achieving the desired outcome, emphasizing the importance of selecting an experienced provider.

Juvederm: Juvederm is another hyaluronic acid filler that offers a range of products tailored to different needs. For glabellar lines, Juvederm products such as Juvederm Ultra XC can be used to provide volume and smooth out the skin. The effects of Juvederm can last up to a year, making it a longer-lasting option for those looking to minimize the appearance of their 11 lines. The smooth gel consistency of Juvederm allows for a comfortable injection process and immediate results, with the added benefit of being reversible if necessary.

Safety Considerations for Filler Injections in the Glabella Area

Safety is vital when considering filler injections in the glabella area due to the complexity of the facial anatomy and the potential for serious complications.

Risks of Vascular Compromise

Skin Necrosis: Skin necrosis is a rare but serious complication that can occur when filler injections accidentally enter a blood vessel, obstructing blood flow. This can lead to tissue death if not promptly recognized and treated. Symptoms may include severe pain, a dusky or purplish discoloration, and skin breakdown. To minimize the risk, practitioners must have a thorough understanding of facial anatomy and use careful injection techniques. In the event of vascular occlusion, immediate intervention with hyaluronidase, an enzyme that dissolves hyaluronic acid fillers, and other supportive measures are critical to restore blood flow and prevent permanent damage.

Blindness: Although extremely rare, there have been reported cases of blindness following filler injections in the facial area, including the glabella. This catastrophic event can occur if the filler material inadvertently enters the ophthalmic artery or its branches, leading to an embolism that blocks blood flow to the retina. The immediate onset of vision loss following an injection is a medical emergency, and prompt action is required. Practitioners must be aware of the signs and prepared to refer for emergency ophthalmologic care to attempt to save vision.

Importance of Expert Injection Techniques (Cannula vs. Needles)

The choice between using a cannula or needle for filler injections can significantly impact safety outcomes. Cannulas, which are blunt-tipped and flexible, are often favored in high-risk areas like the glabella because they are less likely to pierce blood vessels, reducing the risk of vascular complications. Needles, on the other hand, offer more precision but carry a higher risk of inadvertently entering a blood vessel. An expert injector will choose the appropriate tool based on the specific treatment area, the type of filler being used, and the individual patient’s anatomy, always prioritizing safety and efficacy.

Frequently Asked Questions

Can deep 11 lines be treated effectively without Botox?

Deep 11 lines can be addressed with alternative treatments such as dermal fillers, microneedling, PRP, and laser therapies, which can improve skin texture and stimulate collagen production.

What are the risks associated with fillers in the glabella region?

The risks include vascular compromise leading to skin necrosis or blindness, infection, and an unnatural appearance if not injected properly.

How long do fillers last in the 11 lines area?

Fillers in the glabellar region typically last from six months to over a year, depending on the type of filler used and the individual's metabolism.

Are there non-invasive alternatives to fillers for treating 11 lines?

Yes, there are non-invasive alternatives such as topical wrinkle fillers, serums with active ingredients like retinol, and various skincare treatments that target signs of aging.

How can I ensure natural-looking results when getting fillers for 11 lines?

Choose an experienced provider, communicate your aesthetic goals clearly, and opt for a conservative approach to avoid overcorrection.

Can fillers completely erase 11 lines?

Fillers can significantly reduce the appearance of 11 lines, but results vary; complete erasure is not always possible, especially for deeply etched lines.


In conclusion, while Botox remains a primary treatment for glabellar lines, a combination of therapies including fillers, microneedling, and laser treatments can offer comprehensive results. Safety is paramount, with the choice of an experienced provider being crucial to minimize risks and achieve a natural appearance. Topical alternatives provide additional options for those seeking less invasive methods. Ultimately, a personalized approach tailored to each individual's needs and the severity of their 11 lines will yield the best outcomes.

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Tansatit, T., Uruwan, S., & Rungsawang, C. (2021). The Crest Injection Technique for Glabellar Line Correction and the Paracentral Artery.

Dr. Aurora Kalmanson

Always Consult a Medical Specialist

The information provided in this blog is for informational and educational purposes only and should not be interpreted as personalized medical advice. It's crucial to understand that while we are medical professionals, the insights and advice we provide are based on general research and studies. They are not tailored to individual health needs or conditions. Thus, it is essential to consult directly with a healthcare provider who can offer personalized medical advice relevant to your specific situation.