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Are Botox touch-ups not good for me?

My doc charges by area. I had my forehead treated and 10 days later I still have wrinkles in the upper part. I called the doc about touch ups. He said touch-ups are done by other offices because the botox used is weak and I would develope antibodies bit infected more than 4 months. Is this right?

Doctor Answers 9

Botox Touch Ups and Other Botox Myths

Regarding: "Are Botox touch-ups not good for me?
My doc charges by area. I had my forehead treated and 10 days later I still have wrinkles in the upper part. I called the doc about touch ups. He said touch-ups are done by other offices because the botox used is weak and I would develope antibodies bit infected more than 4 months. Is this right

A little information is a dangerous thing. You are partially right and your doctor MAY be partially right.

Botox treatments SHOULD be done by the number of FRESH units administered NOT by area. As a rule, men would require more units than women, if treated by areas, does this mean your doctor injects his female patients more than they need to be injected?

By injecting a specific number of units into each patient and seeing them back in 10-14 days your Doctor can tell how many units YOU need rather than guessing and selling you Botox you may not need. As a result, touch ups are not necessarily a bad thing when seeing a new patient. Once you and your doctor know how many Botox units are required, you  should not need touch ups since he will know the exact dose you need.

Do some offices use "weak" (over-diluted) Botox? You bet. Some use expired Botox, bootleg Botox bought from Canadian pharmacies and from God knows where. If you are EVER told you are "immune" or "resistant" to Botox, you are probably being treated in one of those places and they are trying to sell you more.

Can repeated use of Botox cause immunity? ONLY in high doses. The TACHYPHYLAXIS process has not really been demonstrated with Botox as it has been with other medications.

It seems you need to read more on Botox and BAD BOTOX. To read the best explanation of Botox and your options on the Internet, go to the link below.

Dr. Peter Aldea

Memphis Plastic Surgeon
5.0 out of 5 stars 81 reviews

6401 Poplar Avenue
Memphis, TN 38119

When are Botox touch ups necessary

Botox takes 10-14 days to fully "kick-in."  Once the effects are in place it may become apparent that more Botox is needed in some locations, especially if it was your first treatment.  I ask every first-time Botox patient to come back two weeks later to see if they need a touch up.  It is very uncommon to develop a resistance to Botox wherein it would stop working for you.  Once it has taken effect and the muscle is relaxed, you can't add more Botox to the same muscle to get a different response but you can certainly give Botox to other areas.

Jordana S. Gilman, MD
Atlanta Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

9900 Medlock Bridge Road
John's Creek, GA 30097

Botox touch ups really shouldn't be necessary very often

Botox touch ups should not be necessary very often if your Botox is done correctly in the first place.  Yes, it is possible to under treat a patient ---and this is the favorable adverse outcome rather than having too much, be too frozen, or droopy in places you didn't want to be.  I try to find what bothers my patients the most about their wrinkles and to treat accordingly.  I also use the concept of "you can always add a little more latter, but you can't take any out"---so, if you do need a touch up, you may need to pay for two to four units, but that is only because I won't give you more than you really need in the first place.  I think it is obsurd to charge "by the area" for Botox as you have no idea what you are paying for.  As a physician, I have to purchase and pay for Botox by the unit and I pass that same pricing structure on to my patients so they know exactly what they are getting for their money.  Stay away from anyone who charges by the area.

Cheryl Lee Eberting, MD
Salt Lake City Dermatologist
4.5 out of 5 stars 3 reviews

144 S. Main Street
Alpine, UT 84004

Botox Touch Ups?

Hi John.  The answer given by your MD is confusing.  We bring every first time Botox patient back 2 weeks after the initial injection to determine final results and at that time, it is not uncommon to provide a touch up to make sure everything looks as promised.  

Touch ups are not a problem, but your injector may be.

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

23211 Hawthorne Blvd.
Torrance, CA 90505

"Are Botox touch ups not good for me?"

In my practice Botox touch ups are available to all my Botox patients at no cost.  I find that this eases the anxiety over getting a bad results knowing that we don't have to over do the Botox on the initial visit.

Hootan Zandifar, MD
Los Angeles Facial Plastic Surgeon

8631 W. Third Street
Los Angeles, CA 90048

Botox touch ups

Every face has anatomy unique to each individual.  There is not a standard dose of botox which can be given to a person.  Touch ups are not unusual, particularly in a patient being treated for the first time.  There is no scientific data to support the notion that touch ups will lead to increased immunity to botox.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 96 reviews

845 N Michigan Avenue
Chicago, IL 60611

Botox touch-ups

That is nonsense!  Botox touch-ups are sometimes performed because in cases where I do it, I may have been very conservative in the upper forehead to avoid eyebrow descent.  I will often have peopel come back in two weeks to see how they responded.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

1049 Fifth Ave
New York, NY 10028

Botox touch-up

Touch-ups after Botox are common and can be done safely 1-2 weeks later if needed. Whoever you choose as your Botox physician should be able to accommodate your wishes.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 30 reviews

2333 W Irving Park Rd
Chicago, IL 60618


Touch ups are commonly done and I think a good policy especially if it is the first time you are being treated by new physician. An early follow up visit after the injection is a good way to check on your response as it can vary for a lot of reasons. At that visit, if persistent muscle activity is seen that you want to improve, there is no problem with giving a small additional amount.

David J. Levens, MD
Coral Springs Plastic Surgeon
5.0 out of 5 stars 36 reviews

1725 University Drive
Coral Springs, FL 33071

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.