4 days post op of Botox, I see no change. Is this normal?

I am on Day 4 with my Botox injections. I had 26 units injected around the forehead and frown lines by a new dermatologist. Just wondering why I see no effect at all when I used to get the same amount of units from 2 other doctors and would see effects by Day 3, when now I see no difference at all. I have a feeling the new doctor was not honest about the units used, or may have not used standard dilution. Is that possible?

Doctor Answers 12

Allow for 2 weeks

It can take about 2 weeks for your results to appear, and even though you may have seen results sooner in previous treatments, you should allow 2 weeks to pass before returning to your injector to discuss your results.

Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews


Botox takes about 2 weeks to see the final results. I would wait 2 weeks and follow up with your doctor if you are still not satisfied with your results.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 457 reviews


It can take up to two weeks to see the results of your Botox injections.  Be patient.  If the result is less, ask the questions you posted here of your dermatologist.

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Onset of effect after treatment with Botox for dynamic rhytids

Botox can take up to a week for full effect, so give it a few more days.  If at 2 weeks you are not completely satisfied with the appearance of the treated areas, follow up with your physician for a "touch-up". 

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews

Still a little bit too early

Hang in there.  It may be another week before the results of the recent Botox injections are apparent.  According to the studies, it takes about three weeks to get the maximum effect after Botox treatment, in the average patient.

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

How Long Until Botox Takes Effect?

  • Some patients respond to Botox injections within a day or two.
  • For other patients it takes longer, even up to two weeks!
  • I'd recommend remaining patient and give it some more time. 
  • Thanks for sharing!

Joshua Cooper, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 44 reviews

Botox-Windsor, ON, Canada, Dr. Radin

I can understand your concern.  For many patients it can take 1-2 weeks to get the full effect of the botox/dysport. I would wait it out for now.  If there is no change, you may need to go back for more.  I wish you the best.

Dr. Daniel Radin, Windsor, ON, Dermatologist

Daniel Radin, MD
Windsor Dermatologist
5.0 out of 5 stars 2 reviews

No change 4 days after Botox

Some patients start seeing the effects of Botox 2-3 days after, however, I normally inform my patients that everyone is different.  Waiting a good 7-14 days after the initial injection will determine if your Botox did not work or if you need additional units.  

John A. Ayala, MD
San Antonio Plastic Surgeon
5.0 out of 5 stars 9 reviews

No change 4 days after Botox

Usually it takes 5-7 days to see the effects of Botox. Some patients may see it a little sooner, and for some it may take as long as 2 weeks before the Botox kicks in. It is possible that your new injector used a different dilution technique and your Botox was not as potent. Also, you want to make sure that you actually did receive Botox and not Xeomin or Dysport. Give it until the 2 week mark and if you still don't see your results then make sure you schedule a follow up with your injector. Good luck!

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 10 reviews

4 days after botox

Give it more time.  Rarely it can take a few weeks to get to maximum effect.  There is no "standard" dilution.  What is more important is the amount of units you are given and where they are given in regards to your specific wishes and anatomy.  If no improvement by 2 weeks I would see the injector back.

John R. Burroughs, MD
Colorado Springs Oculoplastic Surgeon
5.0 out of 5 stars 14 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.