Is it too soon to receive another Botox treatment after 6 weeks?

Question

I received Botox 6 weeks ago. I did not receive the desired effect. I am a 48 year old woman. I received 36 units of botox (total) for my glabella area and for crows feet. The movement in my glabella area has almost completely returned. I only notice a very minimal effect in regards to my crows feet. I would like to have another treatment by a different injector. Is it too soon to receive more botox? Are there any concerns over having another treatment only six week after the initial treatment?

Monica Boen, MD · Answer

Thank you for your question. It would be perfectly safe to schedule more Botox injections six weeks after your first treatment if you are not happy with your results. While Botox seems like a straightforward procedure, it does require expertise to precisely administer the right dosing amount in the exact location that will produce an optimal outcome. I encourage you to find a board-certified cosmetic dermatologist who is also an expert in Botox to discuss your concerns and goals. Good luck to you!

Matthew Richardson, MD · Answer

Each patient's dosing is unique. I have general guidelines that I use for most patients, but I see patients almost every day who were under-dosed elsewhere and say that "Botox doesn't work for them" or they never achieved the results they were looking for. There is plenty of evidence to support that higher doses of neuromodulators like Botox generally result in longer-lasting results. For most female patients, I start with 20 units of Botox to the glabella and 10 units of Botox to the crow's feet, but may have to increase the dosing in some cases. While not common, I have several patients that require 40 units to the glabella in order to see any improvement.  I always recommend speaking with your physician injector to discuss any questions or concerns you might have.All the best,

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  If your Botox effects have worn off, it is possible to seek a second treatment 6 weeks after the first.  With the limited duration of results I would recommend either increasing the dosing you received or try another neuromodulator such as Dysport.  Hope this helps.

Eric Mariotti, MD · Answer

A second round of BOTOX® injections should be just fine, so long as your provider gives it the green light. Some people may want a touch up after an initial injection or would like to see different results that a second treatment could help provide. There are a number of reasons your initial injections may not have produced the desired results, but unless you have BOTOX resistance, a second injection should help you meet your goals.

Cavendish Clinic - Fitzrovia · Answer

Hello, we would always recommend you return to your original doctor or surgeon. I'm not sure from your question if you attended your two week review appointment? Its crucial with Botox that you book a follow up - everyones facial dynamics are different and you will often need a tweakment at 2 weeks to achieve the result you're looking for. My only concern about now retreating in full is there is evidence that if you repeatedly over-treat an area, you can become immune to the effects of Botox, and so be mindful of this. Please contact your original injector, they will be best placed on how to move forward and help you. With thanks, Nurse Lisa

Adam Goodwin, MBBS, FRCS(Plast) · Answer

So if your Botox has been ineffective, there are two possible reasons. Number one is that the Botox batch was either weak or has been stored for too long. This is not unusual and is a common cause of disappointment. The other much less likely cause is it that you are becoming Botox resistant. We hardly ever see true cases of resistance so this is probably not the case. If your Botox has worn off early then of course you should go back to your practitioner and ask for additional units. Ask them to take the Botox from a brand-new cold stored bottle. This should fix your problem. Hope that helps. Regards, Adam Goodwin

Daniela Dadurian, MD · Answer

Hi, thank you for your question. It is safe to proceed with additional Botox. Sometimes patients need touch up treatments. Peak results post injection can be seen at 2 weeks so it is likely you did not receive enough. It is difficult to predetermine how many units you need to achieve your desired results which is why I always have my patients come in 2 weeks post injection for a complimentary follow up and possible touch up. I hope this information helps. Good luck!

Steve G. Bekas, MD · Answer

It is not too soon, and since everyone is different and may require different amounts to achieve their optimal results, I would highly encourage you to return to your provider and express your concerns. Your provider may be able to use a slightly different technique or amount to get you the results you desire.

Anshul Gambhir, MD · Answer

Thank you for your message! It is safe to repeat the Botox that soon after initial injections, however it will usually last 3-4 months for most people. People with higher metabolisms, who exercise frequently, or who are under a higher amount of stress may have the Botox wear off more quickly. I would speak with your new injector about your concerns of effectiveness length!

Sagar Patel, MD · Answer

I would say that if you aren't happy with your results you can gt more after waiting two weeks. I would wait at least that long in general to make sure you effect of Botox is the final effect.

Is it too soon to receive another Botox treatment after 6 weeks?

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