I still frown, should i get more botox? If so where? (photos)

More Botox is not always the answer.  I recommend following up with your injector.  It may be that you need more, or you may benefit from a little filler in the line that is still there.  Be sure you are seeing an experienced injector.  Best of luck to you!

This may be treated with a touch up of Botox and/or in combination with fillers into the etched lines. I recommend getting a formal consultation with a cosmetic dermatologist. Best, Dr. Emer

When patients still are able to frown after Botox treatment, it could mean several things. Sometimes a higher dose is needed, especially in men. Occasionally the entire muscle was not treated and accessory muscles need more out laterally. And in some people, it is just a permanent crease in the skin that requires filler. An experienced injector should know what to do.

Thank you for your question and for sharing your photographs comoyah. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.
It is difficult to make an assessment in the absence of consistent photographs before and after in the same lighting and angles for comparison. However, I hope the information provided here is useful.The appearance of frown lines is variable from person to person. Usually they are in a vertical orientation but sometimes they can be oblique and sometimes a horizontal line is seen across the upper portion of the nasal bridge. The most common variation is to have two parallel lines, hence the common term "11's" to describe them. But some people have one, three, or more lines. Some people also will see a bulge in the area when contracting the muscle. This bulge is smoothened out after a Botox treatment.

The pivotal studies used 20 units of Botox in the glabella area between the brow to address the frown lines. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary. When patients present with concerns about specific wrinkles in the upper face such as the frown lines, I always assess and usually treat the other wrinkles in the upper face including the horizontal forehead wrinkles and crow’s feet. The reason is to maintain a harmonious and natural balance to the appearance of the upper face. The muscles in the glabella which are responsible for the formation of the frown lines serve to pull down on the inner brows when a person frowns. Similarly, the muscles around the eyes which are responsible for the formation of the crow’s feet seen when smiling (orbicularis oculi) are also responsible for pulling down on the brows, but in this case the outer brows. On the other hand, the muscle in the upper forehead which is responsible for the formation of the horizontal forehead wrinkles when a person raises the brows (frontalis) serves to pull the brows upward. If one of these muscles is relaxed with Botox and the others are not, the other muscles will still be active. This will lead to an unbalanced and unnatural appearance of the upper face where the brow can be elevated, depressed, or uneven in shape or position. Therefore, I recommend that my patients take a global approach to the upper face when receiving Botox treatments and treat all three of these areas. Sometimes bunny lines on the bridge of the nose are also treated.
Some people have lines at rest (that is without facial expression) which get deeper with facial expression. In these cases, the wrinkles often do not go away completely. However, I find that if patients continue treatments every three months as recommended the wrinkles smoothen out after approximately one year.
If I had a patient with the concern described here I would want to see consistent before and after photographs both at rest and with animation. I suspect there are some wrinkles at rest, which can be treated as described above. I would also want to know the dose used for each session as possibly a higher dose may be required.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!

BOTOX® will not completely stop your face from moving, nor should it. From what you’ve said, and the photos you’ve provided, it appears that your BOTOX® has worked as it should, although this does not seem to be in line with what you expected. If you want to increase the immobility in your face, further BOTOX® may be possible, however, you should discuss this with your plastic surgeon. You don’t say how long ago your most recent BOTOX® was injected, so bear in mind that it can take up to 2 weeks for full results to be visible.

Your Botox result is good. Some patients are still able to frown after treatment. This could mean several things. A higher dose may be needed, this happens a lot with men. Sometimes the whole muscle was not treated. Also, it could be a permanent crease that requires filler. I recommend seeing your injector for further advice and treatment. 

You still have wrinkles between the brows after 2 Botox sessions. It appears that your wrinkles are deeper and are seen when your face is at rest as well as when you actively contract the muscles with frowning. Botox does not always eliminate etched in wrinkles that are present at rest. Your options include a small amount of filler in that area and/or focusing on procedures that stimulate collagen. Injecting filler in the area can be associated with risks because of the vessels in the area. 

Frown lines can become etched into your skin from years of frowning, and persist even after good Botox/Dysport has taken away the movement in the frown complex. Come for an evaluation and we will be able to resolve it for you. A filler may be necessary. In any case, don't let anyone put more Botox/Dysport in your forehead, since the drop in brow position will get worse. If you have residual glabellar motion, then that could be addressed with additional Botox/Dysport. Otherwise, a filler could address the etched lines. 

You appear to have the correct amount of Botox.  The problem is that your line appears somewhat deep and often you cannot correct it immediately.  Over time (two years) if you continue to maintain the Botox this line will improve.  A small amount of Volbella will also improve the appearance as would Fraxel laser for the fine lines and wrinkles.  Best, Dr. Green

Typically it's best to avoid the "frozen" look.  I'm not sure whether this was the intention of your injector, but putting too much Botox in an area does come with some risk.