Did I Receive the Correct Amount of Botox?

Hello, I had Botox for the first time and had 14 units between the eyebrows and 6 units in the forehead. I was told less was needed for the forehead because I had more between the brows.

It is day two and I see nothing. I know this is normal but I am beginning to wonder if I received the correct amount. I am 37 and do not have wrinkles but did not like the way my forehead wrinkled when I squinted in the sun. My PS said my forehead should be smooth like glass and that he did not want to overdo it for the first time. He also said that he prefers a more natural look with more movement than a frozen look. Thanks so much!

Doctor Answers 14

Botox usually starts to kick in after 2-7 days

I certainly can understand your concerns. It is important to be patient, as it typically takes between 2-7 days before the action of Botox to kick in. In terms of dosage, the amount injected is understandable as this was your first injection. I usually administer about 15 units for a first time patient with mild to slightly moderate lines and furrows in the glabella region.

The amount of Botox used in the forehead region is also titrated, depending upon the patient’s degree of wrinkling, etc. If at two weeks, you still do not appreciate the desired aesthetic result, then I would recommend that you return to your physician injector for additional Botox. Keep track of the total amount of Botox so that you and your physician will know the correct amount required on future injections.

I hope this helps to explain your concerns.

Englewood Plastic Surgeon

Botox for forehead

Thanks for your question -

We typically use between 15 - 25 units for the forehead and glabellar region (each).

At two days you're still early. You usually begin to see results at 4 days with the final effect at about 2 - 4 weeks.

If it seems like you still don't have significant improvement at 2 weeks talk to your injector about a touch-up.

I hope this helps.

Steven H. Williams, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 49 reviews

Botox amount

Treatment of the forehead and the glabella area varies from patient to patient.  Assessment of what you need is performed during an evaluation.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Right amount of Botox

Hi Bella Rosella,

Like Dr. Williams, we ordinarily use between 15 and 25 units for both the glabella and the forehead. It sounds like your dosing in the glabella may be ok given the fact you have no lines currently, but the effect you describe on the forehead will probably not be eliminated with 6 units.

Wait about 7 days and if you are not happy with your results, give your injector a call to return for more. Believe it or not, this MD was probably trying to do you a favor. If he had injected too much on the first visit it could be a lot worse. You can always do a touch-up in the first couple visits to finalize the right dosing for you. Good luck.

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

You Need More

My standard protocol for the glabella is 25 units. For the forehead I'll use anywhere from 75-100 units. Unfortunately, 6 units won't do much.

I hope you paid by the unit.

Christopher L. Hess, MD
Fairfax Plastic Surgeon
4.4 out of 5 stars 33 reviews

Botox results show after at least 2 weeks

You should give Botox at least 3-5 days to "kick in" and at least 2 weeks up to 2 months to see the results. The Botox package insert typically recommends about 20 units to the frown (glabellar lines). You've been forming these wrinkles for well over 20 years. They just don't disappear.

Think about this analogy: if you wear your pants all day long and develop wrinkles and creases and then take them off and put them on a hanger, the wrinkles/creass don't immediately disappear. It takes overnight for the wrinkles to soften and some of the worst wrinkles never go away. The same goes for your forehead.

Once the Botox starts working and the muscles relax, it takes time (2 weeks -2 months) for the established lines and wrinkles to soften. I hope this helps!

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Less is often more with Botox

It is better to do less than more, especially the first time. You describe wrinkling that is dynamic in nature, not resting wrinkles. It is harder to predict the outcome in that situation. Remember, you can always do more Botox. The only way to get less effect is to wait for it to stop working. Give it a few more days.

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 51 reviews

Botox can take 7 to 10 days

The 20 units that your Plastic Surgeon started with is OK. I tell my patients that they should expect results in 7 to 10 days. After two weeks, we recheck new patients and add more Botox if needed.

Daniel Reichner, MD
Newport Beach Plastic Surgeon
4.9 out of 5 stars 45 reviews

First time botox treatment

The number of units you had was probably in the lower range of what is typically used. 20 units between the eyes and 15 units to the forehead are typical doses. I appreciate your injector's conservative approach. Botox begins to take effect between days 2-5 after injection and peaks at 2 weeks. You can always have more units injected later as needed. I hope you enjoy the results.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 5 reviews

This a pretty low dose.

I personally use at least 25 units between the eyebrows and as much as another 25 units in the forehead.

But you will not see the peak effect until 2 weeks after treatment. You can always have more then.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

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.