I still have lines after two Botox treatments. What can I do?

Hi there. I am 30 years old and always had the deep horizontal lines on my forehead when I smiled and made any expression. I recently went in for my first Botox treatment and I feel like I paid quite a bit for just the forhead(475$) after two weeks I still had 3 deep lines on the top of my forehead by the hair line. So I went back for a touch up. Now 10 days after the touch up i have all my lines back. You wouldn't even know that I went for Botox. It's back to exactly how it use to be

Doctor Answers 12


It is unusual for a proper Botox treatment to "wear off" after such a short period of time.  Do you still have full movement of your forehead?  Without examining you and without knowledge of the specifics of the treatment, it is difficult for me to determine exactly what happened.  I would recommend returning to the doctor who performed the procedure and discussing your concerns and issues.  Good luck!

Results after Botox

Thank you for your question lindsaylola5. Botox is a purified protein used to address wrinkles associated with facial expression. The pivotal studies demonstrated that the peak effect of Botox is at 14 days. I have my patients return to the office at this time to take photographs and assess their results. In our office, if patients receive the recommended dose and the results are not perfect at two weeks, we provide complimentary additional units. We stand by our treatments and I think this is fair. We do not provide this guarantee if the dose used during the treatment is lower than what I recommend. Please follow up with your doctor to find the dose used and for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 3 reviews

Botox Concerns

I’m sorry to hear that you’ve had this experience with your first Botox treatment. I recommend returning to your injecting physician to discuss these concerns. That way they can see you in person and determine the best steps to take moving forwards. There is definitely an art to injecting Botox to create an aesthetic outcome that's natural. It's always best to see a board certified physician who has a lot of experience with injecting Botox so that you can get the best possible result. Best of luck!

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.3 out of 5 stars 9 reviews

Botox did not work

Thank you for sharing your question. It would be helpful if you could post before and after photos. It is unusual to see no improvements following Botox injections. You might want to give it another try with a different doctor or a different product such as Dysport.
Good luck, 

James R. Gordon, MD, FACS, FAAO
New York Oculoplastic Surgeon
5.0 out of 5 stars 140 reviews

Botox and Results

It is unusual that after two treatments with Botox you are not seeing any improvement. Botox and fillers work well in combination. Botox for the movement lines (Crows feet and "11's"), fillers for deep lines that remain at rest and for areas of the face with volume loss. If you are unhappy I suggest returning to your physician and discussing your concerns or consulting with a different board certified dermatologist. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 191 reviews

Botox treats dynamic wrinkles

It is important to see a picture of the area of concern. Wrinkles come in two types, dynamic and static lines. Dynamic wrinkles are lines that are visible with expression while static lines are lines that become etched in due to repeated expressions, aging and environment factors such as sun damage. While Botox can soften static lines and prevent them from getting deeper, it cannot completely remove them. 

Options for for treating static or deep lines include fillers or laser resurfacing. 

All the best

Dr Soni

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 45 reviews

Botox and forehead

Without seeing you or at least a series of pictures it isn't possible to know what is going on. who is injecting you and where are you going> to a doctor or a spa? make sure you see a board certified dermatologist or plastic surgeon

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 4 reviews

Lines on forehead after Botox

Go back to see your injector and discuss your concerns.  If you are not satisfied, then I would recommend that you see another injector.  In my office, all Botox and filler injections are administered by the physician, not by a nurse or lesser trained staff.  I tell all my Botox patients to return to see me if they are not 100% satisfied.  
Dr. Ort

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 25 reviews

Botox - It's not how much you spent, but how many units you received!

Quite unusual for Botox to wear off so quickly. It is important to know how many units you received versus how much you paid or the volume of liquid injected. Doctors dilute Botox differently. Just because "a lot" of volume was injected doesn't mean you got an effective dose. You may have Botox resistance versus not enough was injected versus old/not fresh Botox was injected. In general, Botox lasts 3-6 months. A normal dose for the glabella/lower forehead is 20-35 units depending on how strong the muscles are in that area. For upper forehead anywhere from 10-20 units, depending on the strength of muscle and/or presence of ptosis (forehead sagging). Even when Botox does work and your forehead is "frozen," you may still have horizontal lines because the memory of the creases in your skin. A solution may be to try another doctor or to go back to your original doctor and make him/her let you know the exact number of units used each time to see if you need more. Also, make sure the Botox is freshly reconstituted! Best of luck!

Millicent Odunze-Geers, MD, MPH
Sacramento Physician
4.7 out of 5 stars 6 reviews

Botox injection for forehead lines

It is uncommon for lines to return so quickly and when this does happen it is usually because of under dosing, inappropriate dilution, poor technique or a combination of the 3. I would consider consulting with another injector. Also, Botox and fillers may work better on the forehead in combination, especially in patients with very deep lines and etching. My preferred filler in this situation is Belotero placed superficially.

Shaun Patel, MD
Miami Physician
5.0 out of 5 stars 55 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.