Day 5 After Botox....absolutely No Difference in Glabella!

I had 16 ccs injected between my eyebrows 5 days ago. It is now day 5. I see nothing like the results on the BotoxCosmetic pamphlet. In fact, I can still frown just the same...with the same speed and intensity. I've heard of waiting 2-7 days for full effect...well I haven't seen ANY effect yet. I should mention that I'm only 31 and I workout about 5 days/week, but I followed my dr's post-injection instructions to a T. What gives??

Doctor Answers 34

Wait ten days and then revisit your doctor.

I always inform my patients that Botox and Fillers are "works in progress".  If they are not 100% pleased in 10 days, they should return in 10 days for a follow up procedure. I try to be "perfect" at the first visit, but I would rather undertreat thelateral side of the eyebrows to not cause droop. It is very easy to treat your problem by injecting more Botox. We do not charge for this follow up procedure

San Ramon Dermatologist
4.0 out of 5 stars 4 reviews

No noticeable response from Botox

You may not see any effect for at least 4 - 5 days after Botox(R) injections with a full effect usually at 2 weeks so this lack of response should not be worrisome. Botox(R) is given in "units" and not noted as "cc's" so I would interpret that your received 16 units of Botox(R) which is a fairly low dose on average and may not ultimately be adequate enough for what you would require.

I would suggest following up with your doctor at 3 - 4 weeks after the injections so he/she can reassess you and your outcome.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

No Botox Results After 5 Days?

Hi Teaneck.  Although you should see results after 5 days, we do not bring our first time patients back for a checkup until 14 days.  

In addition to waiting a bit longer, it sounds like you may not have enough product.  Usually at least 20 units (not cc's) are used in the glabella.  

Finally, for deep creases, it may be required to use a dermal filler like Restylane.  If you have this sort of crease in your forehead it should have been discussed with you before treatment.  Call your injector back for a checkup and discuss all these issues with him/her.  Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Botox not working after 5 days

You should definitely see an improvement by now. While it may sometimes take a couple of weeks for a complete response, it is not typical for there to be no improvement after five days. Even if you were under-treated, you should notice some difference. I would recommend seeing your injecting physician for an evaluation.

Ryan Greene, MD, PhD
Fort Lauderdale Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Botox relaxes muscles in 5 days

In my experience botox relaxes muscles in 5 days. The dose of botox and the distribution into specific muscles determines its effectiveness in treating frown lines

Edward Lack, MD
Chicago Dermatologist
3.0 out of 5 stars 5 reviews

You should see your doctor if your Botox has not had any effect 10 days after your procedure.

I read your concern, and you should notice at least some improvement in your appearance. and weakening of your frown muscles by now. The full effect of your Botox will be seen in another 5 days. If it's not working, you should visit your physician for evaluation.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 358 reviews

How long for Botox to work

Typically, we see the effects of Botox treatment within 3-5 days. I have seen patients not respond however until day 7. If you have not responded after that , I would return to your surgeon.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

You may need a redo Botox injection!

Though Botox can take up to two weeks to see full effect, most patients see some changes by 5 days, and if additional time does not give you the results you wished, this may have been due to a number of causes. First, as others have stated, you didn't have 16cc, you may have had 16 units, or 1.6cc of a particular dilution yielding a specific unit dose. This may be inadequate; if you have had this exact amount here before with good results, then it's not an "amount" issue. If this is your first Botox session, check the amount with your injector. More may be necessary.

But there are other possibilities as well. One is that the Botox was warm, agitated, "old," or incorrectly reconstituted. Rare in an office that uses Botox on a regular basis, but all possible. You could even have had a "bad batch" which may be another name for all of the above. I have had occasion to see this, with all the patients I injected from one bottle having "NO results." whatever the cause, it wasn't because I injected it inaccurately or in too-small doses, so it had to be one of the other reasons. Of course, I graciously re-injected these patients without additional charge, and they had fine results, making a case for one of these reasons for Botox "failure."  Rest assured, Botox is manufactured under the strictest guidelines, so if your doctor is using real Botox (or Dysport, the botulinum toxin form another manufacturer), and doing all of the other important things listed above, you should indeed see results in several days or up to two weeks.

BTW, clinics or spas that advertise "Botox days" generally are trying to "use up" the rest of their reconstituted Botox so it doesn't sit over the weekend and lose potency. Beware the Friday Botox days, or the Monday morning Botox deal!

Also, working out after Botox is not recommended for a day or so, to prevent Botox migration from the desired location to areas where it's not wanted or needed, and away from the treatment site(s).

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 207 reviews

Botox not working


Sometimes it takes longer than 5 days for Botox to work.  However, in my experience, the single most common reason fro Botox "not to work" is under dosage. Patients and doctors try to do the most with the least, saving the patient a little bit of money.  I find that many patients need 20 to 25 units in the glabella , especially if they have very strong muscles. I believe it is better to pay a little extra to get the correct dosage rather than go with the minimum and feel like Botox "did not work."

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 26 reviews

Botox at Glabella

Normally, Botox can take 3-7 days to start seeing results. It can take up to 2 weeks. Assuming you had 16 units injected at your glabella, that sounds conservative, but the amount injected can vary from patient to patient depending on how strong your muscle movement is. Usually 20 units are injected into the glabella region with no problems. The good news is that you can get a touch up and have more units injected if you do not see results by 2 weeks.

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.