Distribution of Botox Units in the Glabellar Area

As you can see from the previous posts, you have to individualize both the total dose as well as how it is distributed. All of the clinical trials use 5 standard injection points, one in the midline to get the procerus. However, not everyone has a hyperactive procerus muscle; it causes a horizontal line across the nose between the eyes, while the corrugator muscles cause the more vertically oriented lines between the brows. So the product should be placed where the muscles are the most active, not with the same pattern in everyone.

I generally start from 20 units and adjust from there.  In most women, 20 units tends to more pretty well.  Whereas men generally need a bit more that 20 units to get the desired affect.
Hope that helps.

Most of my female patients need a minimum of 25 units of Botox (50 or more units of Dysport) to obtain a good and acceptable duration of effect. Depending on how much of the corrugator muscle is recruited from the mid forehead, I may use 35 units of Botox (or even more, rarely, in this area). The face is examined at a resting phase and with dynamic expression to gauge the girth of the muscle and determine the number of units of botunlinum toxin needed. 5 or 7 insertion sites might be used for the glabella.

Depending on the size of your frown-muscles, your dose of BOTOX Cosmetic will be around 20 units. I like to check all of my BOTOX patients around a week after injection so satisfaction, and response can be assessed.
I hope this is helpful for you.

In most cases 20 to 25 units of Botox is sufficient to soften the glabellar creases. However, everyone is different and it is important for your injector to keep a careful record the units injected in each specific area. This way, with your next treatment, you can fine tune the number of units to achieve the desired effect. Some patient require up to 50 units to achieve their optimal effect, while other patients only require 15 or 20 units. Good luck with your Botox injections

Typically, dosing of Botulinum Toxin Type A (Botox, Dysport) is related to the activity and strength of the glabellar muscles. In my experience, the average dose for women is 20-25 u Botox (50-63 u Dysport), the average dose for men is 25-30 u Botox (63-75 u Dysport). From time to time, I encounter a patient who requires more or less than this dosing schedule. It is important to realize that dissatisfaction with Botox/ Dysport is probably most frequently associated with under dosing than any other factor.

Not all patients are created equal. Some patients have stronger muscles than others. Some patients have muscles that act differently. This is why if you look at your friends, each of them develops lines differently than the other. For this reason, each patient may require more or less than 20 units of botox per treatment. Having said this, the average is about 20 units.

As stated 20 units of Botox and 50 units of Dysport are the recommended doses to begin treatment. Some patients repsond to smaller doses  while others require higher doses. .

Thank you for your question Elly Nathalie. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.The appearance of frown lines is variable from person to person. Usually they are in a vertical orientation but sometimes they can be oblique and sometimes a horizontal line is seen across the upper portion of the nasal bridge. The most common variation is to have two parallel lines, hence the common term "11's" to describe them. But some people have one, three, or more lines. Some people also will see a bulge in the area when contracting the muscle. This bulge is smoothened out after a Botox treatment.The pivotal studies used 20 units of Botox in the glabella area between the brow to address the frown lines. The most common variation of placement of the product is four units in each of five points in a V-shape pattern. Please see the video demonstration. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary.Although 20 units is a good standard dose to start with, some people require a higher dose because of higher muscle volume. This is common in mature patients, in those with large bulges from expressive faces, and in men. I find that Botox still works in these cases, just a higher dose is required. I have used up to 40 units in the glabella.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!

I usually use a standard 5-6 injections over the region that treats the procerus, depressors and the corrugators. Usually, that translates to about 12.5-15 units of Botox.