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Does the Number of Injections Have Anything to Do with Botox Results?

asked 3 years ago by RobinLee in Dallas, TX
Latest answer by Jessica J. Krant, MD, MPH
Question viewed 1,248 times

I recently moved from LA to Dallas and was ready for my 2nd Botox treatment. The laws are different here, and you don't have to be a doctor or nurse to inject.

In LA, I was injected with 28 units for lines across the forehead and the ones between my eyes. She only needed to inject me in 8 places or so. I was super happy with the results! My face looked more open and fresh. Two days ago in Dallas, I went to a "Derm Spa" and the esthetician used 25 units, but "poked" me all over the place! My forehead looked like major hail damage! Seriously, like 20 injection sites, and I don't think she even got the area between my eyebrows! I have a small bruise, but at least the redness and bumps went down. Why is there such a huge difference? Is it possible she did it wrong? Is it safe for me to go back for the lines between my eyebrows?

15 answers to Does the Number of Injections Have Anything to Do with Botox Results?

Botox injection styles will vary

In the situation you described, we would not necessarily state that one procedure was better than the other. The first concern would be how are the results? If the results are good, the second question we would have is how comfortable the procedure was for the patient. If we can get the same results with less injection sites, we will, just because it's easier on the patient. If you're not happy with the results or not excited about being "poked" so many times again, we would... more

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

www.celibre.com

Number of Botox injections and amount of fluid are not important.

It can be hard to understand whether Botox is being done properly because it really is an art. How much to put and where to put it are best decided by a board-certified dermatologist or plastic surgeon. Because of the different dilutions used, the actual fluid volume injected is not necessarily directly relevant to how many units were placed in a given spot. Additionally, because Botox spreads to a small degree, the same effect can be achieved in a few different ways with varying numbers... more

Jessica J. Krant, MD, MPH
Manhattan Dermatologic Surgeon

www.ArtofDermatology.com

The amount of units is important for best results with Botox

Botox is measured in units and not in the number of injections. Is is always best to have Botox injected with an experience doctor of nurse. Before you considering going back or going elsewhere for retreatment, you need to wait 14 days for your first Botox injection to take affect. Should you require more Botox, the injector will know then if it has worked successfully in the initial target area.

David A. F. Ellis, MD
Toronto Facial Plastic Surgeon

The right number of Botox injections

There is no perfect number of Botox injections. Each treatment should be individualized for the patient, their anatomy, and their aesthetic goals. Typically the patient needs to the three injections in the area of the crows feet. The number of injections in the four head may vary depending on the effect the patient wishes to create the Botox. The majority of my patients enjoy erasing the central brow lines but leaving enough animation in the lateral brow to not completely... more

B. Pat Pazmino, MD
Miami Plastic Surgeon

Research the individual who will be performing your Botox treatment

Although there is no standard number of units or number of injections per site, it is wise to consult with a board certified plastic surgeon prior to your next treatment. Unfortunately, many health care assistants do not have the same training and experience as board certified plastic sureons. I would recommend seeing out a board certified plastic sureon who can appropriately evaluate your anatomy and administer and monitor the appropriate amount of Botox to achieve your desired results.... more

David A. Robinson, MD
Munster Plastic Surgeon

If you were not totally happy, I would seek out a plastic surgeon to do your Botox

Whereas there are certainly non-physician injectors that do a great job with Botox and fillers, a physician, especially a true plastic surgeon, has much more training and experience and may have a different opinion about what exactly would be best for your face. There is a reason for those California laws!!!

Caroline H. Chester, MD
Nashville Plastic Surgeon

Sounds a bit unconventional, but if it worked well again...

There are different ways to do things and still get good results. If 10 days post treatment you are again happy with the result, then the second provider found a different way to get a good result. If not, you may want to find a different injector for next time. Twenty injections for just the forehead sounds like a lot. Closer to ten is more conventional. The glabella (between eyebrows) usually requires 5-7 in my hands. It is always wiser to have your treatments done by the most... more

Bruce K. Barach, MD
Schenectady Plastic Surgeon

Injection techniques for Botox

Botox can be constituted in varying dilutions and all are equally effective based on the absolute quantity of botox injected. There are varying techniques for injection depending on the experience and overall practice emphasis of the practitioner. In any case, the botox injections should be based on the severity and overall distribution of the wrinkles. After injection, it is possible to inject more botox to correct any residual wrinkles.

Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon

Botox injextions

Like making chicken soup, everyone does it differently. I couldn't tell you why one did it one way and another did it a different way. Just find someone who does it right for you.

Steven Wallach, MD
Manhattan Plastic Surgeon

The only thing that matters is how you look at two weeks.

To RobinLee, Hi! The number of injections can vary. I personally use about 7 injections for the forehead and about 5 more injections for the area between the eyebrows. And you have to meticulously avoid the little veins under the skin: otherwise you get bruising. In general, stick with a board certified plastic surgeon or dermatologist.

George J. Beraka, MD
Manhattan Plastic Surgeon

No - It is injection targeting, the Botox dose and your sensitivity

Hello, You probably just had enough of the Botox by the second set of injections. You can also make antibodies to it at some point, making your response to the drug lessen. I have tried a few such patients on Myobloc and it works better, but the response varies. Best Regards

John P. Di Saia, MD
Orange Plastic Surgeon

Botox: Dose, concentration/dilution, and number of injections help determine the result

Botox injection is somewhat of an art and skill and different "artists" use different techniques. The result is a combination of: Total units given Concentration/dose/dilution Number of injections Diffusion (up to 3 cm = 1.2 in) To give a simple analogy, injecting botox is like laying down several inkspots and predicting an exact pattern each and every time. If you paint, you can appreciate that you will obtain a more precise result If you lay down more pigment (dose) using a... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Different Botox injection technique

Hi Robin, It is still too early to see a result. Botox usually takes 4 to 7 days to work. What you are seeing are the differences in the technique between the two people injecting. Twenty sounds like a rather large number of shots! If you are not happy with the treatment, you may want to seek out someone you feel more comfortable with. You have the right to demand that a doctor treat you. sek

Scott E. Kasden, MD
Dallas Plastic Surgeon

There is not one correct technique

Robin, There are many techniques for injecting Botox and different techniques may be better for different people. The most important thing is that you find a qualified injector that you like and who gives you good results. Injection results will depend on the Botox concentration, number of injections, location of injections, depth of injections, time between injections, etc. So there are many factors at play here. Good luck with your next Botox. I hope this was helpful.

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

Generally, no.

Botox diffuses up to 3 cm or so from the point of injection, so 7 or 8 appropriately spaced injections is usually sufficient for the forehead. The esthetician did not do anything wrong per se, but I would generally suggest that you have your procedures performed by a qualified physician. I am familiar with several estheticians and they are very good at what they are trained to do. The estheticians I know agree that injecting Botox is simply not within their scope of practice. Even if an... more