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No Difference After 2 Botox Injections in Frown Lines? (photo)

2 Quick question: I had never had Botox before. One month ago I went for Botox to get rid of my frown lines. After 2 weeks I saw virtually no difference. I returned and he did a touch-up. I am on Day 8 of the touch up. The first photo show my relaxed face, and the second shows when I make a scowl. Do these results look typical? Do you think it can still improve without further treatment?

Doctor Answers (13)

No response from Botox

+2

From looking at your pictures it appears as if you still have quite a bit of movement. Before you give up on Botox try a different injector.  Most of the time it is the placement and amount of the product used.  Get a copy of your treatment chart and find out how many units are being used and what injection points.  You may need more than the average client. 

I do want to caution you however on expectations. At rest you have a glabellar crease that  would be categorized as moderate on one side and  severe on the other.  At your first treatment I would expect immobility of the muscle complex but not the complete removal of the etched lines.  This will take time and additional treatment modalities like fillers or laser resurfacing.


Portland General Surgeon

I Can Still Frown after Botox

+1

Hi Momof4.  You have too much movement to have had a good Botox injection.  It would be interesting to know how many units were injected as we do not know without that information whether this is a problem with the amount of product or a problem with your injector.  

If you had approximately 20 units of Botox, which is quite standard for what we see in the picture, you should have little or no muscle movement in the frown lines between the eyes.  Given that you do have a lot of movement, you could return to the same injector and ask for the job to be done correctly or try someone new.

Possible problems:

1.  Too little product

2.  Expired or bad product

3.  Bad injection technique

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

Persistent glabellar furrows after Botox treatment

+1

Your results do not look typical as you still have excessive movement of your corrugators (the muscles creating your 11s).  Possible issues: poor injection technique/placement, insufficient dosage, and less likely - defective product or patient resistance to Botox.  The most likely is related to technique or insufficient dose.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

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Botox for Frown Lines

+1

Botox is very effective for treating the lines between your eyebrows when you frown. It is necessary to have the right dose and the right points of injection. The recommended dose to treat the glabellar frown lines (or 11's) which you are showing is 20 units. The dose may vary between  individuals, but if a certain dose is not met, there will not be an effect. Also, if your lines remain at rest before treatment they may require additional treatments such as fillers, laser, or repeat botox injections to completely treat them.

Michael Horn, MD
Chicago Plastic Surgeon
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No change after Botox is injected in the frown lines?

+1

From the photos you provided, your frown lines do not appear to be an issue. But it is difficult to give you precise advice without seeing your before photos. Did you also have Botox injected to improve the appearance of your glabella, or what may also be referred to as the "11's" which are between the brow? Your result can be further enhanced by having this area treated. In general, Botox works great for the frown lines, smoker's lines above the upper lip, glabella, bunny lines, and crow's feet. I hope this helps answer your question, and I wish you the best of luck.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
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Botox and frown lines

+1

It is unclear how many units of Botox you had injected into this area and where the specific injections were. If you are visiting a reputable, well-trained, and experience provider-they will know that there is typically a minimum amount that is effective for the glabella region. It can take up to two weeks to see the results, especially if it's your first time receiving treatment.

Sam Naficy, MD
Seattle Facial Plastic Surgeon
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Botox for frown lines

+1

It appears that your frown has been minimized with Botox and you still have a bit of movement but you have deep creases that Botox alone will not help.  You require filler to plump up the creases and perhaps more Botox to relax the frown movement.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
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No response from Botox of frown lines

+1

I agree with Dr. Janoff.  This is an ideal area for improvement with Botox so I would try another injector before giving up on this option.  In addition, once Botox properly takes effect you will notice the lines remaining noticeable.  I would recommend a laser resurfacing treatment to help soften these lines while Botox is in effect.  If in the end, Botox does not work for you, there are still many options available to help soften this area.  Don't give up and good luck to you.

Richard W. Maack, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

No Difference After 2 Botox Injections in Frown Lines? (photo)

+1

Thanks for the question and posting excellent photos. What comes to mind is either your galbellar/corrugator muscles are SOOO strong or the injected BOTOX was took diluted. Try another injecting doctor and ask for freshly mixed BOTOX in front of you. Try another 20 units to begin with. If there is still no response than you might consider the need for fillers and possible incisional muscle surgery. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Botox and glabella lines

+1

Without performing the procedure for you, I can not say why it has not worked for you. Perhaps you need to see another injector.

Steven Wallach, MD
Manhattan Plastic Surgeon
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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.