Do I Need a Botox Topup?

Question

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?

David Hansen, MD · Answer

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

Otto Joseph Placik, MD · Answer

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.

Paul Vitenas, Jr., MD · Answer

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.

John Philip Connors III, MD · Answer

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 office depends on your goals, the amount of movement I see and the goals we discuss. Talk to your doctor.

	Good Luck!

	Dr. C

	johnconnorsmd.com

Ron Shelton, MD · Answer

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.

Eric M. Joseph, MD · Answer

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.

Theda C. Kontis, MD · Answer

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.

Kenneth D. Steinsapir, MD · Answer

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.

Martie Gidon, MD, FRCPC, FAAD · Answer

As long as the movement is symmetrical and appears natural, you probably do not require more Botox.  If you are not certain, please return to your physician for assessment.

Catherine Huang-Begovic, MD, FACS · Answer

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 Begovic M.D.

Do I Need a Botox Topup?

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