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Do I Need a Botox Topup?

asked 1 year ago by Corkgirl in Toronto, ON
Latest answer by James McMahan, MD
Question viewed 983 times
Tags: dosage, frown lines, glabellar lines

I'm 33 and got my first ever Botox injection for glabellar lines 13 days ago. The doctor I went to said he usually uses 25 units so I presume that's what he actually gave! He told me top-ups were free if I wasn't happy with the effect 5 days later. It definitely made it harder to frown but there's a tiny twitch of movement left. Difficult to even see if lighting is poor. I suspect there might be a bit more when I frown unconsciously. Should I go back for more or is this an acceptable result?

21 answers to Do I Need a Botox Topup?

Some movement is normal and natural looking after botox injections.

Some movement is the correct end point with botox injections. It looks natural and is the ideal result. You don't want no movement at all since that looks fake and too obvious. Sincerely, David Hansen,MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon

www.DrDavidHansen.com

Still have some residual frown activity after Botulinum Toxin (Botox and Dysport) injection

The frown lines can be created by several different groups of muscles. Therefore some residual activity is normal and complete paralysis is not desireable or a releastic goal. I would recommend no further injections at this point.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Botox- a good result.

It sounds like you had an appropriate treatment and got a good result. A little movement is always good if you want a natural look. However, if you want the frozen look go back and get a bit more Botox in the area.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon

Botox Results

Your result with Botox, and any cosmetic procedure for that matter, is a personal preference. I assume you discussed your individual goals with your doctor before he or she recommended 25 units? This is a pretty typical dose in this area. Some patients do not want to be frozen completely, others do...personal preference. If you feel you need additional dosing, go for it. I individualize dosing for each patient and do not offer "areas" for a certain price....dosing patients in my off more

John Philip Connors III, MD
Atlanta Plastic Surgeon

Botox - touch up

Whether the result is acceptable is a personal thing. Some patients like to have a little movements still so they look natural, some people like to be completely frozen. If you like the way you look - I'd leave it. If you want to be more frozen, it sounds like your doctor will give you some more Botox free of charge so you should feel comfortable going back. If you have any questions, you should go back to your doctor and talk about it together. Dr. Cat... more

Catherine Huang-Begovic, MD
Beverly Hills Facial Plastic Surgeon

Botox touch up

I normally do not add any Botox till two weeks have gone by. A tiny twitch only seen in good lighting is a good result. There are other muscles in the area that we do not normally go after that can cause this if you frown hard.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon

www.facialsurgerydr.com

A Botox Touch up!

Best to return to discuss with the injector. It sounds as if your result is acceptable but I would want you happy if you were my patient. From MIAMI Dr. Darryl J. Blinski, 305 598 0091

Darryl J. Blinski, MD
Miami Plastic Surgeon

Slight movement after botox

It sounds as though this may be the correct result with the neurotoxin treatment. The neurotoxin only works on the muscles that are injected- there may be a small amount of movement seen when you use ALL of your forehead muscles (from the non-injected muscles contracting against the injected ones). To have a completely frozen forehead is not a natural outcome.

Purvisha Patel, MD
Germantown Dermatologist

First Botox treatment of forehead--some movement is normal

Since this is your first Botox treatment, it is understandable that you are not sure what is a normal or typical result. Occasionally there is a little muscle movement after Botox treatment, but if the "11's" between your eyes are better, you probably had a satisfactory result. I suggest you go back to the doctor and ask if your result is acceptable. If not, usually a small "boost" to the muscle will stop any residual movement.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon

facialplasticsurgerymd.com

Go get a top off

The doctor put his foot in it by essentially guaranteeing your satisfaction. Go make yourself happy and get a top off! Happiness is entirely subjective so I don't think it make a whole lot of sense but that is not your issue.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Some motion is more natural after Botox

It is not unusual to have some residual motion after Botox injections. Complete lack of muscle motion is less natural looking and gives more of a mask-like appearance. If you have just minimal motion that is hard to see, I wouldn't worry about it. If you have obvious motion that is more than what you want, I would go back in for a touch-up injection.

James McMahan, MD
Columbus Plastic Surgeon

Botox to the glabellar frown lines doesn't need to be completely frozen...unless you want it to

Having a little twitch of movement after having Botox to the glabellar frown area is normal and a perfectly good result. If your goal is complete paralysis, then more Botox can certainly be done. But most patients don't require a completely frozen area between their eyebrows as this can look unusual compared to the rest of their forehead movement.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon

Do I Need a Botox Topup?

No, you do not need a touch up, and the result is excellent. If you ever do a touch up , wait at least 2-3 weeks. Ramtin Kassir, MD Facial Plastic Surgeon NY, NJ

Ramtin Kassir, MD
New York Facial Plastic Surgeon

Wait two weeks to three for full Botox effect

I would not suggest having any more Botox now unless the muscle movement is easily seen and two to three weeks have passed for maximal effect of the onset of action of Botox injections.

Ronald Shelton, MD
Manhattan Dermatologist

A Frozen Forehead is NOT the Goal of Botox Treatment

Regarding: "Do I Need a Botox Topup? I'm 33 and got my first ever Botox injection for glabellar lines 13 days ago. The doctor I went to said he usually uses 25 units so I presume that's what he actually gave! He told me top-ups were free if I wasn't happy with the effect 5 days later. It definitely made it harder to frown but there's a tiny twitch of movement left. Difficult to even see if lighting is poor. I suspect there might be a bit more when I frown... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Botox Touch up

Usually it takes 5 days to START working and full effect of Botox injections is after 10 days so I would wait. Everybody is different as for how many units you will need. the first time you receive Botox is never a great indication of how many you will need in the future. I would wait about 2 weeks before getting a touch up and then go back at 3 months to re-evaluate the results.

Henri P. Gaboriau, MD
Seattle Facial Plastic Surgeon

Your final result from Botox will be evident around 10 days after your treatment.

25u Botox is a good dose for glabella wrinkles. You should wait another 5 days to judge your result. Make a follow-up with your doctor in 5 days and you'll both decide whether a dose adjustment is necessary. All the best from NJ.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

How soon does one need additional Botox?

Even though you may see some smoothing of the wrinkles after just a few days, normally it takes up to 2 weeks to see the full effect of botox on the injected area. So deciding whether you need more Botox after just 5 days is too early. Also, you don't want a frozen face after any kind of cosmetic procedure. You do want some movement left, otherwise it will look unnatural. The goal of cosmetic procedures is for you to love the way you look, not the way your Botox looks. more

Emily Altman, MD
Short Hills Dermatologic Surgeon

Botox'd it and it still moves after 5 days...

When botox is injected, it must get to the right location and do its thing, and that takes some time. Normally, we expect to see significant improvement very quickly, but the maximal effects may not be seen for a week or more. At 5 days post treatment, I would wait a few more days. After the first treatment, i usually recommend that patients come back to see me for followup so that I can see if the result is what is expected or not. Some patients will need more, some... more