Botox Injected Right?

I have injections in the muscles themselves and injection holes in the wrinkle itself. Also, he gave me 3 forhead injections for wrinkles but just put them on the lateral sides, very near to the hairline. My friend with identical lines had the lateral injections and additional 3 injections vertically in the middle of the forhead? Which is proper?

Doctor Answers 15

Find a qualified doctor and stop worrying

I have found that when patients worry about the details of a procedure, it is usually because they choose someone who is not qualified. There are a lot of faux dermatologists and non-plastic surgeons out there injecting patients. Go to a board certified dermatologist or plastic surgeon with lots of injectable experience. The pattern is so variable there is no way to know if it was done right. Choose the best doctor and leave the details to her/him.

New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

Botox injection sites

Since botox works at the muscle level, I personally don't find it useful to inject into the skin wrinkle itself.  I ask my patients to be specific with me about which part of their upper facial wrinkles are bothersome to them, and then design a regimen to fit their needs.

Jeff Scott, MD
Everett Plastic Surgeon
5.0 out of 5 stars 10 reviews

Botox injection technique needs to be individualized

Since no two people have exactly the same facial muscle structure and habits of expression, the placement of Botox needs to be individualized. I am always disappointed when I see "cookie cutter" approaches where the clinician is simply following a diagram that they may have learned in a short course.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Botox injection technique

Every patient is different. and each individual patient also changes over time.  Botox is not a "one size fits all" treatment where you can expect to have the same injection pattern or amount of Botox as your friend even if you think you have the same wrinkles.  Everybody is different, and the physician should tailor the treatment to each patient's needs at that point in time.  I have patients who have been receiving Botox treatments for many years and I don't always do the exact same thing every time they come in.  That is why it is important to see a Board-certified Dermatologist or Plastic Surgeon for your treatments, who has experience performing these procedures.

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

Correct Botox injection technique

You have to individually examine each patient, feel where the muscles are contracting actively, and inject the bellies of the active muscles with the right dose of Botox.  So, even though your friend had similar wrinkles externally, she could possibly have a different underlying muscle size or arrangement, and need a slightly different treatment.    That being said, there certainly are commonly used patterns for treatment.  
Most people don't have a lot of muscle in the upper midline of the forehead, so usually that area is not so essential for treatment.

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 79 reviews

Techniques of Botox injection vary by physician

I do not believe there is a 'right" way to inject the forehead with Botox, but certainly there are 'wrong" ways to inject. When injecting a patient, I analyze  the location and size of the muscles that are causing the wrinkles. I would respond to your question with a question--Are you happy with the results? If so, your doctor's technique is fine. If not, return to the doctor who treated you and explain your concerns. Occasionally just a 'touch up" can give you a great result.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 39 reviews

Botox and Dysport is not the same from patient to patient

The same doctor may change the areas of injections depending on the individual's anatomy, the neighboring muscle groups and contemplate the  droopiness of adjoining areas before injecting Botox or Dysport.  Each patient is separately evaluated.  A particular patient may need different units used in the future and newer insertion sites depending on the effects of age. The physician injecting botox or dysport must utilize science, anatomy and art!

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Results are what count in Botox injections

There are numerous variations on technique that a qualified injector might use. Every patient's anatomy andconcerns are slightly different. What counts is whether you are happy with the results..

Daniel Berg, MD
Seattle Dermatologic Surgeon
3.7 out of 5 stars 3 reviews

Results justify the technique!

Hi Angela In the end, you just want a good result! The answer will be there in 5-7 days. If not you can return for a touchup. Going forward, ask your doctor to explain his treatment technique. Most of us have no problem explaining conceptually how we treat common problems. Choose a well qualified injector or physician with a good reputation in your community. Expect to pay a little more for the best - usually its a wise investment. Best Regards, KC

Kirk A. Churukian, MD
Los Gatos Plastic Surgeon
5.0 out of 5 stars 6 reviews

Placement of Botox injections is individual

The placement of Botox injections depends on the pattern of the dynamic wrinkles and also on the strength of the muscles being treated. The amounts and placement of botox does depend on the patient and on the preference of the injecting physician.  The location of the muscle can be identified by the patient making certain facial gestures.  Then the physician can determine where in that muscle to place the injection.

The injections should be into the muscle tissue itself, as yours are.  The approach through the wrinkle or not is not so important as the injection into the muscle tissue

As far as placement in the forehead, the frontalis muscle is divided into two halves on the lateral areas of the forehead.  As it rises from the brow level, it goes up and out to the sides, so injecting the lateral parts of the forehead works for that.

If the injections are placed too low on the forehead it tends to drop the eyebrows, so injecting higher on the forehead avoids that complication.

Emily Altman, MD
Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 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.