How Come After Botox on my Frown Lines, It Helped a Little,but Did Not Make It All Go Away?

Do i need more units of botax on my frown lines at the touch up sessions? Or do I need a fat transfer, perhaps other types of fillers to perfectly flatten my frown lines?

Doctor Answers 12

Botox did not make the frown lines go away completely

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There is a good way to tell if more Botox would help. Try to make a frown, if there is no inward movement of the brows (towards the midline) then more would not help. If the lines have been set in for a long time (many years) Botox will improve the appearance of the lines but will not erase them. Fillers can help with the residual line. Catch it early in your 20s and 30s and you would have never gotten them in the first place.

Fresno Oculoplastic Surgeon
4.9 out of 5 stars 43 reviews

Botox relaxes frown lines and filler plumps up lines

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Botox relaxes movement but may not totally stop all frowning.  If the lines are still deep, you may require filler to plump up the creases.  Botox treatments are usually about 4 months apart but the filler can last for 6 months or longer.  Please see a board certified dermatologist or plastic surgeon to ensure the best possible results.

Martie Gidon, MD, FRCPC
Toronto Dermatologist

Botox on Frown Lines

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Botox can help relax the muscles in the glabella region to help soften the facial expression as the action of the muscles become less apparent.  However vertical lines between the eyebrows can become permanently etched into the skin. This is the result of years of muscles contractions between the brows which crease the skin.  If this is the case, a dermal filler can help fill in the creases to help them become less noticeable.



Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 33 reviews

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More Botox or Filler

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If your frown lines are deeper or if the injector was overly conservative, you may need additional units. For particularly deep creases, a filler such as juvederm or restylane can help.  To perfectly flatten your frown lines is not a reasonable expectation.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Incomplete treatment with botox

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If your muscles are larger than average in the glabella then you may need more units of Botox than average.  The muscles could still contract after the Botox was injected initially then the doctor determines how many more units were needed..  Other patients may say that the Botox didn't work but the muscles are proven to be 100% relaxed and the lines couldn't fade any further from Botox but they could improve with a mild fillers.       

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Botox won't erase frown lines

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Botox won't erase lines that have been etched in to the skin.  Botox keeps muscles from contracting and increasing the depth or severity of the lines.  Imagine your skin is like a piece of paper...once you fold it and create a crease in the paper even when you unfold it and lay it flat you can still see the impression of the line on the paper.  If the groove is quite deep you may consider a filler in addition to Botox and possibly a laser procedure like Pearl Fractional to help soften the line further.

Good luck~

Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 reviews

Botox Touch Up

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It is likely that you need more units injected to get the best result.  In our practice, we offer a courtesy (no extra charge) follow up at 1-2 weeks after initial treatment to every patient.  This gives us the opportunity to check the results for the patient and to add a little more, if necessary.  In my opinion, it is better to be conservative and go back and add a little more than be too aggressive and cause undesired side effects. I recommend you follow up with the physician who did your injections. Click on the link below to see before and afters of good botox results. 

Channing R. Barnett, MD
Boca Raton Dermatologist
4.1 out of 5 stars 8 reviews

Botox and Frown Lines

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Botox only works on dynamic wrinkles, meaning lines that are formed when you move the associated muscles. If you are standing straight in the mirror and not moving your muscles, but you still have lines on your forehead, these are static wrinkles and Botox cannot work on those. Botox only works on dynamic wrinkles, not static wrinkles - those would need a filler.

Touch up on botox

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Every patient responds differently to Botox. Sometimes physicians are more conservative with Botox injections, and this is not necessarily a bad thing. In our practice, if a touch up is needed after 10 - 12 days, we will be glad to do a free touch up to obtain optimal results.

Jeffrey Adelglass, MD
Dallas Facial Plastic Surgeon
4.3 out of 5 stars 13 reviews

Botox does not erase lines

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Botox works on the musculature to prevent movement of the brows toward the midline. It does not erudite wrinkles. You might consider fillers for the lines; this would reduce the deep creases but fine lines will remain at the superficial level. No such thing as perfect here-only improvement.

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.