Botox consultation: when a doctor suggests corrections you didn't ask for... (photo)

After I asked a questions on RealSelf about botox injections for the horizontal lines in my forehead, I researched qualified injectors in my area and went for a consult with a plastic surgeon. She looked at me and said my right eyebrow is lower than my left and that I should get that fixed. She also quoted many more units than had been suggested by the docs who answered my question here (nearly 50 units for 600$). I've heard only good things about her...but now I have doubts. Second consult?

Doctor Answers 10

Botox consultation

If your doctor recommended 50u of botox she must have quoted you for multiple areas ( glabella, frontallis, crows feet) .  I would say that for the forehead alone it would be anywhere from 8-10 units of botox. Hope that is helpful . 

Toronto Plastic Surgeon
4.9 out of 5 stars 435 reviews

Botox Consultation

Please make sure that your doctor didn't mean 50Units of Dysport and not Botox. If it is Dysport, that dose is appropriate.

Somyos Kunachak, MD
Thailand Facial Plastic Surgeon
4.8 out of 5 stars 16 reviews

Botox consultation: when a doctor suggests corrections you didn't ask for...

50 units of Botox at $600 is not unreasonable for some patients. Obviously, she is suggesting treatment of multiple areas (forehead, between eyebrows, around eyes and possibly under the eyebrow). I typically see very nice results for the forehead alone with 8-10 units of Botox. I hope this information is helpful for you.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Botox consultation: when a doctor suggests corrections you didn't ask for...

Never a bad idea to obtain second opinions. But sounds like you are hearing good stuff from the first doc... 

Botox Consultation

There is a great difference in an in person consultation and one done with pictures over the internet. This can be one of the reasons for a difference in the suggested treatments. Also, there are multiple ways to treat specific problems. Perhaps the suggestion was for an alternate method other than Botox. Make sure that whomever you see is an expert injector and that you are comfortable with him or her.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 5 reviews

Botox consultation

It is important that you are comfortable with your doctor. If you have any doubts, seek a second opinion and compare the approach and amount of units recommended by the two.

Jeremy A. Benedetti, MD
Saint Petersburg Plastic Surgeon
4.8 out of 5 stars 43 reviews


When you have a consultation, your are seeking a professional opinion.  Although the Plastic Surgeon suggested more units than you were comfortable with, that is not necessarily a red flag.  One point I would make is that when you treat the horizontal lines of the forehead (frontalis muscle), without treating the lower central brow (corrugators), a strange result known as muscle recruitment can occur.  In this situation, the corrugators try to perform the job of the frontalis muscle, leading to a strange hyperfunctional appearance. Although this doesn't always happen, I warn patient s that it is possible. In my opinion, treatment of the corrugators and frontalis (about 40 units) is synergistic and more aesthetically pleasing.  The choice is ultimately up to you.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 84 reviews

Botox Consultation

The most important thing is that you feel comfortable with the doctor that is doing your injections. If you don't feel comfortable with the way your consultation went then you should get a second opinion. Best of luck to you.

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 9 reviews

Botox consultation: when a doctor suggests corrections you didn't ask for...

There is no harm in having a second opinion, especially if you didn't feel perfectly content with the first doctor.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Botox consultation

Thank you for your question. If you are having doubts about your first consultation it never hurts to get a second opinion. It is easier to give an accurate recommendation in person. Each provider may have a slightly different suggestion for you about correcting your areas of concern.

Best Wishes,

Pablo Prichard

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 43 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.