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Botox for Frown Lines - How Many Units Are Normal?

I just went to get rid of my frown lines (forehead) they gave me 46 units of Botox, which is equivalent to 2 syringes... does that sound right?  I don't understand the term units, and I don't want to get ripped off.

Doctor Answers 20

Sounds average

46 units sounds like the average for the area. Give it up to 2 weeks to see an improvement, then return to your injector if you don't see any improvement. Units is the measurement of the actual amount of Botox administered, before it is reconstituted.

Botox for frown lines

The amount of Botox units placed in the forehead is quite variable depending upon which muscle groups( corrugator versus frontalis) are injected. A large person with thick muscles will require much more  Botox than someone very petite with small muscle structure. 45-50 units seems  appropriate for the forehead

William Portuese, MD
Seattle Facial Plastic Surgeon
4.5 out of 5 stars 72 reviews

No rip off here


You weren't ripped off!  Trust your surgeon.  I have said this before and I will say it again.  It doesn't do ANY practitioner ANY good to compromise your result.  It's a basic business concept.  A satisfied customer will always come back!

The amount of Botox required to treat wrinkles varies from individual to individual.

The amount of Botox required to treat wrinkles varies from individual to individual. In general, I use about 50 units to treat the forehead, glabella, and crow’s feet. Some patients may require more and some less. So, it does not appear that you were overcharged.

Thanks for your question.

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Botox Units vs. Areas

It is always preferable to know how many "units" of Botox were used to treat a given area. The pricing is then based on dollars per unit, and you know exactly what you're getting, as well as what you're paying for it, like going to the gas station to fill your tank. A "syringe" means nothing unless you know how many units it contains, and the cost per unit.

I typically use 20 units to treat the "glabellar" frown lines (a.k.a. "11's") between the eyebrows and the root of the nose, and 20 units to treat the horizontal forehead lines. Some patients may require more, or less of a dose, depending on the muscle mass and their sensitivity to the Botox.

Athleo Louis Cambre, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 1 review

25 units is fairly typical.

For just the frown lines (the corrugator supercilii and procerus muscles), I usually start patients with 25 units. The occasional patient requires more depending on the prominence of the muscles.

"Units" are a standardized dose of Botox, where 1 unit was defined as the LD50 for intraperitoneal injections in mice. The LD50 is the "lethal dose, 50%" which means that 50% of the mice injected with 1 unit of Botox in the abdominal cavity were killed. [And before anyone gets nervous, the LD50 for humans is on the order of 3,000 units--more than a hundred times the dose used in the frown lines!]

In addition, you can't compare treatments by number of syringes or by volume (number of milliliters) since various practitioners reconstitute the Botox to different concentrations. Typical concentrations are 2.5 units/0.1ml, 4 units/0.1ml, and 5 units/0.1ml. I prefer to use 2.5 units/ml so that I can more evenly treat the muscles (10 injection points with smaller doses at each site...but then I also numb the patient first since it is more "shots").

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Botox dosing for frown lines

The correct dosage of Botox is the smallest amount necessary to achieve the desired effect.
I typically use one syringe (25 units) of Botox for the glabellar frown lines.  If this provides insufficient improvement, then a larger dosage of Botox can be used for subsequent injections.  46 units is an unusually large dosage to the glabella for most women, though it is sometimes an appropriate dosage for men (who usually have stronger muscles in this area).  

Ronald Friedman, MD
Plano Plastic Surgeon
5.0 out of 5 stars 24 reviews

Botox for Frown Lines - How Many Units Are Normal

For the Frown lines it is normal to use between 20 - 30 units of Botox.
Giving more Botox units is of no benefit. It is like filling a 50 litre gas tank with 60 litres. The 10 litres will overflow and serve no purpose.

Botox for Frown Lines - How Many Units Are Normal?

The amount of Botox used for frown lines can vary from 25 – 50 units for the forehead, glabella and lateral periorbital areas. Some men have stronger corrugator muscles with more pull and therefore need more units in the glabella area.  It is a good idea to follow up with your physician after 2 weeks to assess the effect of the Botox and touch up if needed.

Thomas Guillot, MD
Baton Rouge Plastic Surgeon
4.5 out of 5 stars 12 reviews

What is a Botox "unit"

Botox units are just a measure of the Botox delivered.  Every person requires slightly different amounts.  The number of syringes is not an accurate measure since the Botox is diluted in saline to any volume necessary.  So there could be more Botox in one syringe of a doctor then 3 syringes from another doctor - depending on how much they dilute the Botox.  Most patients start out around 50 units for their first treatment.  The effects are then observed and the treatments are fine tuned on subsequent treatments.  46 units just for your forehead is a little high to start with, but if they would also treating the area between your eyebrows, your glabella, they it sounds like they got it just about right.  Hopefully you are happy with your results.  Good luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 66 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.