Very Little Change After Botox on Forehead

Hi! Cannot be sure without seeing you, of course.  But almost all of our Botox patients in New York get significant improvement with 25 units after 12 days.

Annie, It may take a few treatments of Botox to eventually smooth your forehead.  Look in the mirror and try to raise your eyebrows.  If you are unable to raise them, then your Botox is working.  Patience.

Botox does not treat wrinkles, it treats the muscles that make them. Therefore one should not expect prominent horizontal lines of the forehead to go away after one injection. Be patient, with continued ,regular use of Botox, the lines should soften because the muscles that created them have been weakened.

botox for the horizontal lines on the forehead is tricky. If you put too much in you drop the eyebrows and create a heavy upper lid. Put too little in and you don't get an effect. I would recommend going back to the doctor and getting a little more Botox. If you don't respond to more Botox you may be someone who has Botox anti-bodies and Botox does not work for you.

You may get further improvement over the next few days.  If not, your doctor may be correct, you may need an additional dose of botox.  The amount of botox required to paralize a muscle and subsequently cause the overlying wrinkles to resolve is dependent on the size and mass/strength of the muscle and the number of neuromusclar receptors in the muslce.   This can vary greatly amoung different individuals. 

Dear Annie, As the post above attest, there could be MANY reasons why your Botox treatment may have been a disappointment to you. By 12 days you would have seen a complete effect of the Botox. So - the period of elapsed time is not the answer. Nor do I believe that your surgeon would have partially treated your frontalis muscles generated wrinkles without telling you as some of the above posts was suggesting. Yes -- weakening the frontalis in people who need it to prevent upper eyelid... more

It is difficult to answer this question without actually seeing you. There are many factors that come into play here. If you did not receive enough botox, then you would still be able to move your forehead muscles and make the lines. However, if you are not able to move your forehead, but still see lines across your forehead, this is because the lines have been there for so long, they are what you called a "static crease", meaning even if you stretch out the skin, the line is... more

If you have had forehead lines for a while, it will take a while to soften them up. Of course, Botox is designed to treat the underlying muscles that cause the wrinkles, but it does not actually change the skin. So, after the muscles are paralyzed, and done so on a continuous basis (meaning you have to keep up with re-treatments), eventually the wrinkles should soften up. Sun damage, smoking, etc. can damage the skin and work to increase wrinkling. Protecting the skin, exfoliation and... more

Your doctor did nothing wrong, nor is Botox not being effective. If you give high doses to the forehead, the brows will drop. We often need additional treatments to improve lines that are not just from facial muscle movement, but from sun damage too. Laser and filler are two complementing treatments to Botox in this area. Go see your doctor to discuss the options.

Botox works well for dynamic lines and usually will help within 2 weeks.  Lines that are present at rest may take months to remodel and may take up to 3 cycles of Botox over a year to remodel and smooth out,

There could be many explanations. In my mind, the practical issue is to get good results next time you have Botox. Ask your doctor to administer freshly prepared botox in sufficient concentration. If the forehead has many strong lines, you might need 25-40 units to get a complete correction. Best of luck!

Botox works by irreversibly inhibiting Acetylcholine release at the neural synapse. It takes 3-5 days for the remaining Acetylcholine stores to be used up, and as they are used up, the Botox will take effect. Waiting additional days will not enhance the results. If you feel that you did not see results, have a frank discussion with your plastic surgeon about the administered Botox and determine if you need additional units of the Botulinum toxin.

A number of things can cause this lack of effect. First, there are some people for whom Botox just does not seem to work. Perhaps, they have pre-existing antibodies to the material. Or maybe their synapses repair themselves so quickly the Botox has a limited effect. Maybe the BOTOX did not work from the company. Air should not enter the vial, if a even a minute amount did, then this inactivates the BOTOX. I once had three patients who all told me their effect was minimal. Since all... more