Is 45 Units of Botox Too Much?

The amount of
botox needed to treat vertical frown lines varies from patient to patient and
depends on several variables. These include patients aesthetic goals and the
strength of their underlying glabeller muscles.

In the vast
majority of patients , 46 units of botox would be more than enough to
adequately treat vertical frown lines. Patients don't usually see a response
for 2 to 3 days following injection. This response continues to improve for 5
to 7 days following the procedure.

Rarely,
vertical frown lines are still present after adequate botox injections. This
occurs when deeply etched frown lines are tethered to the deeper
structures.  Under these
circumstances, injectable dermal fillers may be necessary to adequately treat
the problem.

If you’re concerned
about vertical frown lines, consultation with a physician with experience
treating this type of problem is appropriate. This physician should
be able to outline a plan that's appropriate for you.

The average dose for treating the frontalis muscle (horizontal forehead lines) is 15-20 units to achieve a measurable response.  The average dose for treating the glabella (11's) is 20 units.  45 units is not unusual in treating both areas of the forehead, but would be a very large dose to treat the frontalis muscle alone.

no one can comment on what is best for you without examininig you in person. I evaluate my patients by seeing their lines at rest and with muscle contraction. I also examine the mass of the affected muscle with contraction and get a sense as to how many units they will need. Smaller muscle mass gets the lower end of the spectrum, and larger gets the higher amount, but first-time patients that I treat do not get the highest amount the first treatment.

If you have two lines between 2 - 3 inches, and if the lines are not too far apart from one another, then botox insertions can be placed in between the lines and placed about 2/3 of an inch apart to allow for the 1 cm. of diffusion. Conceivably, then, 10 units might be enough, however, there are some physicians that will not treat the forehead without treating the area between the eyebrows to allow for lifting since the treatment of the forehead may drop the forehead.  There is a good possibllity that if your lines are not too obvious, that the treatment can be done without the glabella and if the 4o+ units are injected throughout the forehead you might not like your "frozen" appearance. It's only a few weeks that your doctor is returning, why don't you wait to be more comfortable with the treatment, even if this new doctor has a great reputation?