Customized Botox?

I'm on my third day of my second ever Botox treatment and I still hate the results. I have fake Hollywood face again.

Does anyone have advice on how to interview cosmetic centers to find out the level of consultation they offer? I’m looking for a customized injection pattern or dosage that can minimize my problem areas without killing my face.

Each place I’ve called had vapid sounding receptionists offering to set consultation appointments for $40 to $65 but didn't hear what I was looking for.

Doctor Answers 6

Let's get clear

First, if I understand you, you had Botox injections 3 days ago. Botox doesn't work befor 3 or 4 to 7 days after injection, so I don't know what your results are due to.

Secondly, every treatment is customized. Botox must be injected in selected areas to work properly. It is not like going to Luby's where you can pick and choose randomly where you want it.

Please give it a chance to work.


Dallas Plastic Surgeon
4.7 out of 5 stars 101 reviews

Customized Botox

Customized Botox is a must for the discerning patient.

The very intricate balance of facial muscles is unique to each patient.

Your doctor should consider minor asymmetries, the degrees of aging of the face, the repurcussions of each and every area injected.

It is not recommended to go from doctor to doctor, since no single doctor can develop the fine touch and customization required by the discerning patient if they are seen only once. Customization only occurs as an observant physician notices the effects of Botox on each area of the face, appreciates the changes over time, and the fine eccentricities of the patient.

For patients interested in Botox to the crow's feet, forehead and frown lines administered in an assembly line type fashion, ignore the above.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Customizing Botox

Thanks for your question -

Typically Botox can take 3-7 days to fully take effect.

Botox injections are really always customized (or should be). Facial anatomy, depth of the wrinkles, skin tone and previous treatments are all key guides to getting a good result.

In your case careful discussion with your doctor about your previous results with Botox will likely be very helpful as you have a specific amount of correction you're looking for.

Find a plastic surgeon that is willing to take the time to sit down with you and carefully discuss your goals with you. Sometimes injections can be treated as a bit of a commodity.

I hope this helps.

Steven H. Williams, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 49 reviews

Botox injections customized

For most patients, the effect of Botox starts to kick in between 3 and 7 days. It sounds like this second injection round was being used to attempt to counter the effects of your previous results that you were not happy with.

Each Botox treatment is, or should be, customized to accomodate for the individuals muscle bulk, and their expression lines/wrinkles. Depending on the market where you live, physicians will charge $50 to 100 dollars for consultation. Some consultations are complimentary. This time is important to give you an opportunity to speak with the physician and find out what their injection philosophy is, if they have great listening skills, and if you feel comfortable with them treating you. This is not the kind of information a receptionist can give over the phone.

Ask your friends who are happy with their results, who their injector is and take the time to schedule a consultation with these specific physicians/providers to see if you like their approach.

You may need to wait out the effects of this round of Botox, if you continue to be unhappy with the results as it kicks in. You can then go to a new injector with a "blank canvas" that they can treat conservatively so that you are happy with your results.

Good Luck!

Anifat Balogun, MD
Seattle Otolaryngologist

Customized Botox

My suggestion would be to find out how many units were injected to each site from the office of your recent injector. Most physicians are pretty careful about such documentation. Do some more research on the reputations of physician injectors in your area and once you find that individual, bring this information with you and discuss your concerns. Hopefully you will find someone who takes into account individual variation in muscle bulk, brow positioning and natural asymmetries as well as someone who is generally conservative in the amount of Botox used at your initial consultation as it is far less of an interruption to your life to do a touch-up 2 weeks after the injection than for you to wait 3 months for the effects of Botox to wear off.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 5 reviews

All Botox should be customized

What separates Botox injectors is the ability to adjust and customize treatments. It is relatively easy to learn the injection points and place a specified amount of Botox into each area. The art of Botox is to evaluate the individual musculature and existing lines and wrinkles, and place the appropriate amount of Botox into the muscle to inhibit contracture. Each person has to be treated differently, depending on this assessment, thus customization.

It also sounds like you have been seeing injectors who are a bit heavy on the dosage. You should ask to speak to the physician who will be performing the injections. ( When you call ask to speak with the physician, if he will not talk to you, go on to the next one). Ask about his philosophy about injections ( on a practical level...number of units in forehead for instance....not ona metaphorical level).

I trust you are seeing physicians who are board certilfied in dermatology or plastic surgery. If not , you should be.

Good luck. You are paing good money so your satisfaction in the procedure should be paramount.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 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.