48 yr old questioning botox results on eleven lines and feeling dissatisfied. Exam & injects by nurse @ ps office. (photo)

Got 1st time botox two mths ago on eleven lines. See pics before/after. 1st visit nurse suggested and I received 25 units for eleven lines. 2 wks later nurse & I agreed lines still visible so she added 3 more units for total of 28 units for eleven lines. Still see these lines when I make expressions. Am I suppose to? I don't know what results should be. Also got 6 units on forehead as suggested. (& Got 3 units each crows ft & 2 unit each outer brow (lift) but maybe wasn't enough.) Opinions?

Doctor Answers 18

Botox for elevens

Since your eleven lines are very deep, one botox treatment may not completely eliminate your lines. As you do additional treatments every three or four months, the eleven lines will become more smooth. If you want the lines smooth faster, ancillary treatments such as filler or laser along with the botox will help. If you have any motion of that area when trying to move it, a higher dose of botox would stop the dymamic component of the lines.

Chicago Plastic Surgeon
4.4 out of 5 stars 54 reviews

48 year old questioning Botox results on eleven lines and feeling dissatisfied.

Thank you for your question. If you still have movement consider additional units 2 weeks post treatment. If you do not have movement but the lines remain, you may have deep set lines that require more than one Botox treatment to smooth and possible filler to the area to smooth completely.

All the best,

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

Lines after botox

The skin has an outer and supporting layer of skin. In certain places of the face, muscles attach to the bottom of the supporting layer of skin. After years of the muscles flexing the skin, the collagen breaks down, creating a wrinkle.
 When we rest the muscle with BOTOX, this allows the skin, an opportunity to begin to repair itself. By the end of the BOTOX treatment, the skin is stronger. When the wrinkle is deep , it may take a couple of BOTOX treatments before the line disappears completely. Be patient, if you want to speed up the rebuilding process, consider a good exfoliation skin program including RetinA.

Brian Maloney, MD, FACS
Atlanta Facial Plastic Surgeon
4.7 out of 5 stars 30 reviews

Botox and "eleven" lines

Hello lmdinep,

Thank you for posting your question. From the pictures you provided, it appears that you have had some improvement. Botox does not erase lines. However, treatment can significantly reduce the severity. Over time, with repeated treatment at the recommended interval of 3-4 months, most patients can see a nice relaxation of the lines. I suggest continuing treatment with Botox and adding in treatment with laser resurfacing or filler to get the best effect. Hope this helps!

Best Wishes,
Dr. Michael J. Brown
Northern Virginia Plastic Surgeon

Michael J. Brown, MD
Ashburn Plastic Surgeon
4.8 out of 5 stars 33 reviews


That is a very good question. All of the neurotoxins take time to work and the results are not instant. You need to give the injections at least one full week. The duration of treatment is approximately 3 months.

Jay H. Ross, MD, FACS
Palm Harbor Plastic Surgeon
4.6 out of 5 stars 31 reviews

Botox and Glabellar Lines -- Often needs MORE than botox -- lasers, fillers

its likely you need fillers and needed fillers to begin with.  often botox is only improvement and some movement is natural.  you will prevent long term wrinkles but some that you have at rest need lasers and fillers for more improvement.  Best, Dr. emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Botox and Deep Glabella Lines

If you have deep glabella lines, it will take several treatments over the course of time to have your skin "smoothed out".  I always explain that it is like paper that has been folded and you need to "iron out" the crease.  You might also benefit from filler in that area.  Please consult a board certified dermatologist with expertise with facial injections.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

48 yr old questioning botox results on eleven lines and feeling dissatisfied

It's always difficult to evaluate Botox results based on static images. However, it does appear that you've had improvement even though some movement persists. 20 units of Botox is typically adequate in that area for most patients. You do have a component of imprinted lines that have been folded into your skin. They will likely require a small amount of filler to lift and smooth those etched in lines. I hope this information is helpful for you.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews


Hi Imdinep
Thank you for your question and pictures.  Botox is not made to get rid of the lines completely, especially your first time.  Botox works by relaxing the muslces so your not constantly contracting those muslces which in turn is making the lines more prominent.  If you are not able to contract your muscles with expression then the botox is working.  Once you are able to start contracting those muscles again then you know its time to go in for another treatment.  Botox will last anywhere from 3-6 months.  Every patient is different. Stay consistent with your botox treatments and you will see and improvement with repetative use over time. Best regards

Sugene Kim, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 76 reviews

Botox in Glabella

Botox does not fill in lines.  It works by relaxing the muscles which cause lines.  From the pictures, it looks like there was some improvement.  I don't see as much muscle activity in the after pictures.  The lines which are etched in won't be completely gone after a single Botox treatment, but they tend to improve if you keep up with the Botox and repeat it every 3-4 months or so.  It is possible to inject filler into the etched-in lines as well.  I do recommend continuing the Botox or the lines will just get worse over time.  

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