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Is 45 Units of Botox Too Much?

asked 9 months ago by BrittB in Seattle
Latest answer by Ronald Shelton, MD
Question viewed 1,223 times
Tags: age 25-34, forehead, female

I have always gotten 10 units on my forehead. although it didnt remove every line it looked smooth when my muscle was relaxed & lasted 3 months. i went 2 a new doctor becaue mine is out of town for 3 weeks and he insisted on 45 units! I'm only 26. there's only two small lines 2-3inches long that show up with no muscle movement? Is this outrageous amount?

25 answers to Is 45 Units of Botox Too Much?

When is too much Botox too much?

As other panel members had suggested, it is difficult to make a judgement without knowing if you received treatment to the forehead in addition to the frown lines (glabella area) which are considered two separate treatment areas. Oftentimes, patients confuse the two areas. A general rule of thumb is that horizontal lines are related to forehead movement whereas the vertical lines ("11's") are glabellar in nature. This is important when knowing a... more

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

www.celibre.com

45 units for a 26 year old?

I am not sure that any of the experts who answer this question can truly know what is right for you. I do agree that 10 units is way too low.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon

How many units of Botox are enough?

No one can comment on what is best for you without examininig you in person. I evaluate my patients by seeing their lines at rest and with muscle contraction. I also examine the mass of the affected muscle with contraction and get a sense as to how many units they will need. Smaller muscle mass gets the lower end of the spectrum, and larger gets the higher amount, but first-time patients that I treat do not get the highest amount the first treatment. If you have two lines between 2 - 3... more

Ronald Shelton, MD
Manhattan Dermatologist

Too much Botox

Well, a larger dose might give you a more dramatic change if injected over a more broad area, that can be everything from more wrinkle reduction and a pleasing result to too much weakening and a falling of the brows. There is no right or wrong dose though as what is needed to achieve an effect can vary from patient to patient.

Julio Garcia, MD
Las Vegas Plastic Surgeon

45 Units of Botox too much?

You are 26 years old and 10 units of Botox seem to work for treatment of your glabellar lines. Most likely you have a very minor wrinkle problem and therefore I would stick with the 10 units. 45 units sounds almost too much even for the treatment of the glabellar lines, frontal lines, crow's feet. and bunny lines and I'm not sure that you have these lines. I would wait for the Dr who first treated you. Always make sure that you are being treated by... more

Eugene Mandrea, MD
Chicago Dermatologist

Too much Botox

45 units seems a little high to me given your age but 10 units seems way low (at lease for the corregator muscles that create the scowl lines) You question raises the important issue of continuity. It's important to establish care with a doctor for filler and Botox. It's very difficult to see patients who have been to many doctors and had a little Botox here, a little Dysport there, a little Restylane here and a little Juvederm there. You get the... more

Lisa L. Sowder, MD
Seattle Plastic Surgeon

Botox dosage

In treating the forehead, crow's feet, and the "11" lines of the corrugator muscles, I usually place about 40-50 units. However, a 26 year old is a bit young unless there is significant premature aging.

Steven Wallach, MD
Manhattan Plastic Surgeon

How much Botox is too much?

Botox and Dysport contain botulinum, and since they are drugs, proper dosing might vary. Some patients and doctors seem to believe one goal is to completely reduce muscle activity so there seems to be a "frozen" appearance. Others believe that results should be more subtle, leaving some muscle function that allows basic expression, (ie, appearing interested or surprised when you ARE actually interested or surprised). So the dose of Botox or Dysport can be calculated... more

Donn R. Chatham, MD
Louisville Facial Plastic Surgeon

Possibly too much if 10 worked well!

If 10 units gave you good results, jumping to 45 units may be excessive for you. Make sure your physician is listening- your physician should never "insist" on using more Botox than you are requesting, especially if you have a history of injections and know how much you need! If you feel you are being pushed into more than you want, get another opinion. Good luck!

Catherine Winslow, MD
Indianapolis Facial Plastic Surgeon

www.indyface.com

What is the right amount of Botox to use?

If 10 units of Botox worked then 10 units of Botox was enough. You are wasting your money if you receive more and the doctor is making more. You know, you are the boss here. You are the consumer. This is not a life and death decision. Insist on what you want based on previous good experiences. Otherwise leave this Botox seller and wait the 3 weeks for your regular doctor or go to someone who has the good sense and wisdom to actually listen to you.

Harlow Hollis, MD
Victoria Plastic Surgeon

Botox dosing for forehead

There is no one "correct" botox dose as you must take into account a person's muscle activity, muscle thickness and what level of decreased motion is wanted. I'm not entirely clear which part of the forehead you've been having treated (glabella area between your eyebrows or the forehead above), but the main point is that if 10 units gave you the results you liked then that is great. 45 units may be the plan for more global treatment of both the glabella and forehead... more

Thomas A Lamperti, MD
Seattle Facial Plastic Surgeon

With experience I find myself injected fewer units, not more

For a patient your age, 45 units of Botox would be more than necessary to cover both the vertical lines (glabellar lines) that you are describing, as well as your forehead. Not every line will disappear, but the effect should be a natural result with some retained motion. If you are seeking out treatment of just the vertical lines between your brows, often 12-18 units in a female is usually enough to gain the desired result. The longer I am in practice, I'm noticing the fewer number of... more

Jeffrey D. Hoefflin, MD
Los Angeles Plastic Surgeon

How much Botox is enough

Botox treatments can be more or less aggressive and the "right" amount depends on the amount that creates the look you want. Medicine is both an art and a science. You need to find the doctor that is a good fit for your sense of what looks good and stick with him or her. Fourty five units doesn't sound unusual depending on the situation. But it is a lot different than ten units. You are obviously seeing two providers with very different philosophies. It is up to you to decide which, if... more

Daryl K. Hoffman, MD
Los Gatos Plastic Surgeon

www.dkhoffmanmd.com

45 units of Botox for a full forehead treatment may not be an excessive amount.

When treating your whole forehead, 25-50 units of Botox may be necessary. This would be injected in the frown area along with the muscle that elevates your brow. 10 units of Botox is a small dose that may benefit one area but not two. I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

10 units versus 45 units of Botox

With the addition of new neurotoxins, "botox" is getting more complicated for patients. It sounds like you might need to clarify exactly what muscles are being targeted (your forehead versus the area in between your eyebrows, or both?), and whether a different toxin (Dysport) is going to be used. That sounds like a reasonable dose of Dysport for just the forehead - I have never injected that much Botox into the forehead and feel that it would be overkill... more

Michelle Spring, MD
Marina Del Rey Plastic Surgeon

Units of Botox

You are 26 and therefore probably don't have many lines on your forehead to treat. The original dose of 10 units seems reasonable. The dose of 45 units of Botox to the forehead alone would seem excessive to me. The new doctor may be recommending to treat the glabella wrinkles, "11" area, also. Both forehead and glabella together could amount to 45 units. There is another product similar to Botox called Dysport. The dosing of Dysport... more

Steven Svehlak, MD
Los Angeles Plastic Surgeon

Too much botox

Not if the treatment is for the entire forehead as well as the glabellar frown lines. See how you like the result and how long it lasts compared to what you usually receive. If you prefer the result from the smaller amount that you have gotten in the past then be certain to return to that doctor only when this wears off.

Michael L. Schwartz, MD
West Palm Beach Plastic Surgeon

No, 45 units of Botox is within the reasonable dose range.

No, 45 units of Botox is withing the reasonable dose. Some injectors are more skilled and may do a more thorough, longer lasting treatment. If your doctor is an experienced and skilled specialist in aesthetic medicine the 45 units was probably well placed.

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon

www.gatewaylasercenter.com

Botox dosing is important

I suspect that the physician evaluating you recommended that dose based on a treatment plan that included the forhead lines, 'eleven' lines, and possibly crow's feet. This injection pattern is typically done together because it preserves brow position and also yields a nice cosmetic result. When the forehead is treated in isolation, a lowered brow position can result.

Scott Sattler, MD
Bellevue Plastic Surgeon

It is not an outrageous amount.

However, it is probably much more than you need also. The issue with this product is how to use it as efficiently as possible. That way you do not pay for more than you need. 45 units in the 11 lines for someone your age is unlikely to be necessary. My advice is this: if you were happy with you prior doctor, stick with them. This is not a simple commodity. Precisely how the treatment is performed makes a big difference to your outcome. more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Botox Quantity in Forehead and Glabella

It appears that even other physicians don't understand this concept, 45 units of Botox is 45 units of Botox. Dilution plays no part in the number 45, only in how much liquid it takes to give you 45 units. So if he said he gave you 45 units, the only way you didn't get 45 units is if he lied, dilution plays no role in that. Treating both the forehead and glabella with a total of 45 units is pretty typical. If only one or the other were treated, that would be... more

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon

www.dr-apo.com

Botox Units

How much Botox someone needs to acheive a good result is based on the size of the muscles being treated and the experience of the doctor to determine how many units will relax those muscles. The number of units is a universal way of describing the strength of your treatment regardless of the way in which it is diluted. Treating the forehead without treating the "11" area (glabella) can cause droopy or heavy brows, because once the forehead muscles are weakened, there is... more

Brett S. Kotlus, MD
Rochester Oculoplastic Surgeon

Forehead

Ten units is not enough to completely treat a forehead. However 45 unit seems high. Are you sure he didn't switch you to Dysport as that unit total for Dysport is closer to correct.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon