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Botox: Forehead or Glabellar?

I've been getting 28 total units for forehead lines and crow's feet (no glabellar). I don't have a big problem with the glabellar area, but to save money, will I get a similar effect by having the glabellar injected and not the forehead?

Doctor Answers (30)

Save money, but don't skimp on your results

+3

A common misconception about Botox is that a patient can spread units around - keeping overall units used low (and costs lower), yet still treating several areas of the face.  If you try this, you will only waste the money you are trying to save.  If you are trying to save money, my advice would be to choose the single area of your face that bothers you the most (i.e. crows feet, forehead lines etc) and treat that area, but treat with enough units where you will actually achieve the result you are seeking.  The goal is for you to be happy with the outcome and for the product to work for you.  30 units total should be enough to effectively treat the glabella (20units) and the crows feet (10units) in most patients.  If you want to continue treating your forehead lines as well, you should use additional units - otherwise you will likely not be completely satisfied with your results.   


Seattle Facial Plastic Surgeon
5.0 out of 5 stars 137 reviews

Understand Botox: the treatment areas are not interchangeable to save money

+2

The muscles of the glabella pull the brows together and downward. The frontalis muscle under the forehead lifts the brows. Putting Botox (or Dysport) in these muscles can actually do opposite things. The traditional amount of Botox for the glabella is close to 20 units. Placing Botox here, and in other areas like the lateral orbital rims (crow's feet) can help elevate the brow so that less is needed for the frontalis muscle. However, it is unlikely you will save money trying to avoid treating the areas needed. It might even cost more. Have a careful discussion with your dermatolgist or plastic surgeon before she starts injecting.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
5.0 out of 5 stars 40 reviews

How Many Units of Botox do I Need?

+2

Hi makeitadouble.  The glabella is almost universally 20 units unless you are male or have extremely strong facial musculature in this area.  The crow's feet varies a bit more depending on the patient, but we are usually injecting between 15- 25 units in this area.  So, based on what you are currently having injected, we would provide a heavier dose for you for the areas you have interest in.

There are two other points we would like to address.  The first is how good your results are.  Botox results should last 3-4 months.  In most cases when you are under dosed, the results simply do not last as long.  Have your results been lasting this long?  If not, you may not be saving any money at the 28 unit level.

The second is whether or not you need the glabella treated.  It appears from the picture that you may not.  We do not see the vertical "11" lines in the glabella area and wonder if you should just stick the the current areas you are treating.  Hope this helps and good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

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Undertreating with Botox is a Waste of Money

+1
The most likely patient to be unhappy with neurotoxin treatment (Botox, Dysport, Xeomin) is the under-treated patient.  As Dr. Naficy pointed out, the concept of "spreading around units" is nothing but a waste of money.  Just as you would treat a headache with the appropriate dose of Ibuprofen, undertreating muscle activity with toxins leads to minimal or no result.  I have never seen a patient have an acceptable response with Botox with less than 20 units per area.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

Botox for the forehead and glabella

+1

The muscles that cause forehead lines are different from the muscles that cause the glabellar frown. Injecting your glabella will not help your forehead lines.  If you do not have frown lines, continue to treat your forehead lines and crow's feet.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 15 reviews

Botox effect in glabella is not the same as the forehead

+1

Your photograph shows no lines in the glabella or forehead. Just some smile related crows feet.  If you want to maintain the effect of Botox which apparently has made you happy by limiting or erasing the lines on the forehead and crows' feet, then you should stay with that.  The glabella and forehead are two dynamically different areas.  It actually is VERY unusual that I only treat the forehead without treating the glabella because there can be a droop of the forehead if the glabella is not treated to help lift.  Furthermore, the number of units to treat a forehead usually is smaller than the glabellar treatment, so you would not necessarily save money by changing the treatment.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

You can’t really save money injecting one and not the other

+1

In terms of injecting the glabella area in the forehead with botox , you can’t really save money injecting one and not the other.  It’s a question of whether one needs to be injected over the other to look the best.  The glabella area lowers the eye brows while the forehead raises the eye brows.   So if you inject one and not the other, you’re going to affect the eye brow position (which may be good or may be bad – depending on what you are trying to achieve).  If the eye brows are in a good position, then you really need to inject the glabella area or the brow depressors, otherwise you’re weakening one and the other will pull the brows down.  Or if you just inject the glabella, the brows will go up slightly and usually that’s preferred when the brows need to be lifted a little bit.  But it’s important to treat the glabella and the forehead together, whether you treat the crow’s feet or not, because that’s what’s going to determine the eye brow position which is a very important consideration for the overall look.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
5.0 out of 5 stars 20 reviews

Botox for Glabellar and Forehead area

+1

The glabellar area involves different muscles than the forehead so you will not get the same effect by not treating the forehead.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.5 out of 5 stars 26 reviews

Botox for upper face

+1

No you will NOT save money. Injecting forehead alone requires less units. If the question was the other way around...you do save money by injecting the glabella if you are wanting glabella AND forehead, but not vice versa. Frequently, people want both. I usually inject glabella, which naturally gets some forehead, then have the patient come back in a week for touch up of the forehead (to save money).

Tracy Kuykendall, MD
Tulsa Dermatologist
5.0 out of 5 stars 3 reviews

Treat each area well

+1

You might be able to save a little, but not much. The glabella area generally needs about 20 units to be adequately treated. If you do not have much to do there, you might be able to use 15 units.  That would still take you up to about 25 to 28 units if you include the crows feet.

I'm glad you realize you can't spread the units too thinly over too many areas. This would just give incomplete results. In addition, going too light on the dose seems to give even shorter results, and botox duration is short enough as it is!

It is worth discussing in detail with your doctor what your specific goals are and how to get the most "bang for your buck".  

Christopher J. Peers, MD
South Bend Facial Plastic Surgeon
4.5 out of 5 stars 7 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.