I'm 51 yrs old. Why Didn't my Doctor Give Me Enough Botox? (photo)

First time I had treatment, he gave me fillers and botox, and I was very,very impressed with the results. Then I came back for more botox, as I thought I needed a touch-up after 3 months. However, he didn't seem to give me much of it, saying I still had enough in some areas. I was not very impressed with the results at all, as I did not want my botox to run out completely. He did not charge me for it, but why is he doing that? I'm 51, well preserved.

Doctor Answers 11

Not enough Botox

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Botox lasts 3-4 months.  It is recommended that you overlap treatments so that the Botox doesn't completely wear off and the muscles stay weakened.  Good communication with your Botox provider with help get you the results you are looking for.

East Brunswick Plastic Surgeon

Enough botox

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overdosing botox is much worse than undertreatment. complications occur if over treated. if you do not have enough muscle motion to absorb the botox, then the botox can "move" to other areas you do not want treated. I suggest you return to the doctor and discuss things with him. maybe he thought you wanted a free treatment, maybe you did not have enough motion to give a full treatment.

Rick Rosen, MD
Norwalk Plastic Surgeon
4.8 out of 5 stars 28 reviews

Botox Dosing

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As the panel members suggested, your question is better directed to your physician for an explanation.  It would appear that your injector is being conservative and mindful of your pocket book - good things.

If there is little muscle movement, than the treatment plan should be modified.


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

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Botox dosing/touch ups

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The exact reason for the lower dosage can only be answered by your physician.  But when I change up the dosage it usually is because there is not enough movement of the intended muscle group to visualize the ends of the muscles.  This is especially important in the glabellar where lid or brow ptosis may occur if the toxin is injected to far lateral.  I will give my clients a choice, smaller dosage today or wait a few more weeks/months until there is appropriate muscle activity. 

Lee Robinson, MD - RETIRED
Portland Facial Plastic Surgeon

This Question Would Best Be Answered by the Doctor Involved

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Botox will only last for 3 months.  Therefore, I wouldn't describe the return at 3 months as a touch-up, but more as a second treatment.  As far as the Botox dosing is concerned, no one can answer that question except for the Doctor involved.  I would recommend a frank discussion with your Doctor about your expectations

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

Botox works well for wrinkles

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He probably thought the Botox was still working well for you and did not want to give you too much, which could cause a side effect (e.g. drroopy brow or eyelids). Not sure why he did not charge you. 

Botox works on dynamic wrinkles (i.e. wrinkles caused by underlying facial muscular activity or movement);  wrinkles of the forehead, glabella (between the eyebrows) and lateral eyes (crow's feet) are the most common.

Try to animate these facial muscles and create wrinkles to see if your Botox is working.  If you cannot elevate your eyebrows or wrinkle your glabellar area or create crow's feet when you smile, then your Botox is working.  Your Botox may be working even though you still have wrinkles at rest (without trying to animate these areas.)  Botox should last 3-6 months.  Otherwise, if you are not sure, see your doctor again, and offer to pay for more Botox or get another opinion from a board certified Dermatologist. 

Robert Strimling, MD
Las Vegas Dermatologist
4.3 out of 5 stars 9 reviews

BOTOX® Cosmetic should be repeated before effect wears off.

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You are right to go back for a treatment before your Botox has completely worn off. It is important to understand that many doctors treat their patients differently and some may be more conservative with their Botox dosage to ensure a natural looking treatment. Over doing it can lead to the Botox moving into another area where we do not want to restrict movement. Don't be shy to speak to your doctor about your issues, good communication will help you to achieve your goals

Manish Khanna, MD, FRCP(C)
Montreal Dermatologic Surgeon
4.6 out of 5 stars 27 reviews

Three months deserves more botox possibly

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Botox for most of my patients wears off starting around the three month time and continues to four months where most of the muscle activity returns. It is not unusual to do a full treatment at three months to maintain the lack of motion so the lines stay away. There are times that I have suggested to my patient that they wait one more month as they still had fair relaxation and they would save some money with less botox treatments per year. Many have agreed, but some do prefer to treat sooner rather than later.

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

Botox effect

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I can't speak for another doctor but usually less may be given if I feel the muscle is still weak and won't need as much. In my practice patients pay by the unit, not the area so if they need more they just come back and I add a little more. They only pay for the extra units received.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Long ago I stopped arguing with patients about when I thought they were ready for more botox.

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It is not reasonable to expect your doctor to top off your botox for free after 3 months!!!.  How long does BOTOX last? 3 to 4 months but some people feel they are ready for more after 2 months.  Personally I think your doctor is foolish to offer to free touch.  An experienced injector should be able to very accurately assess how much Botox your need.  If you are doing honest treatment there is really no need to offer free additional treatment.  On the other hand it is not really reasonable for you to expect free treatment after 3 months.  No wonder your doctor is not generous.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 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.