What if I Don't Hear the Crunch Sound with Botox? Does That Mean It Was Not Injected Deeply Enough?

Doctor Answers 10

Botox and a "crunch" sound

Normally, I hear this sound only when injecting into tough forehead skin.  It isn't something that you should expect to hear when being injected.  

Salt Lake City Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

Botox is excellent for softening the

I'm guessing that you've also been using a retinoid or having other rejuvenation treatments because the fact that you're not hearing the "crunch" sound means that either the doctor changed the needles they were using and these are of a better quality, that they're changing the needles as they go along with the injections since it's a dull needle that can make that sound, or that your skin is healthier due to rejuvenation treatments and the needle is passing through healthier collagen as it goes through the skin to the muscle. All of these are good outcomes and you may notice that you have less pain and bruising from the treatments as well.

Doris Day, MD
New York Dermatologic Surgeon

Botox and Dysport do not have to have a "crunch" sound to be effective.

Coco,  Any crunching sound during Botox injection doesn't relate to whether it will be effective. Some doctors automatically inject very deep (perhaps sometimes deeper than necessary) and a crunching sound or sensation may be common especially in the forehead area where the fascia layer (tough connective tissue) is more robust around the thin muscle layer. Whether the Botox or Dysport works is related only to the freshness of the batch and the skill of the doctor, not the actual sound.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews


The crunch sound is usually due to the needle being dull.  I have found that if I remove the rubber cap on the botox bottle and draw up the botox directly into the syringe instead of through the rubber cap, the needle stays sharp.  The "crunch" has nothing to do with the level of injection. 

John Landi, MD
Naples General Surgeon
5.0 out of 5 stars 5 reviews

Why do I hear a noise when I get Botox?

I have found that the noise associated with Botox injections (usually only present in the glabellar area) is due to a dull needle.  I always use a separate needle to draw up the product and a fresh needle to perform the injection.  My patients tell me this makes the injection more comfortable and we rarely hear the "crunch."  That sound is created by a dull needle passing through the fascia which covers the muscles which we treat with the botox.  Only in the glabella is that fascia thick enough to make a noise. 

Assuming you had an experienced injector, you can still expect a great result from your Botox, even if you didn't hear any crunch.  The medicine takes about 5 days to start working and reaches full effect by 2 weeks.  If your results are not satisfactory after 2 weeks, discuss with your physician.  

Best wishes!

Michael Bowman, MD
Roanoke Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

The Botox crunch

The only place that I would expect that you might hear this sound is on the forehead but it is not part of the treatment and not necessary for success. I think that a sharper needle might have less crunch to it. 

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 18 reviews

Crunch Sound with Botox

The presence or absence of a crunching sound has no correlation with the efficacy of the Botox injected; this sound is caused by penetration of one or multiple durable, sliding tissue planes in the forehead.  The frontalis muscle, which produces the horizontal forehead lines, lies immediately deep to the subcutaneous brow fat.  Injection into or superficial to the muscle does not seem to correlate with result.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 reviews

Crunch sound from Botox

There doesn't have to be an associated "crunch sound" for Botox to work. Sometimes you might hear it, other times not, and some people may never hear it. It doesn't matter - it's not what means Botox was or was not injected correctly.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Sound When Botox Is Injected

There is no required sound associated with Botox injections. Whether or not you hear anything has no bearing on the outcome of your treatment. 

Channing R. Barnett, MD
New York Dermatologist
4.1 out of 5 stars 8 reviews

Botox and sound

Having the expectation that you should hear a "crunch" sound when receiving Botox injections to your facial muscles is incorrect. Sometimes it occurs, and sometimes it doesn't. It has no bearing on whether or not the treatment was injected at the right depth, that is completely injector specific, and certain muscles lie deeper than others.  

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 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.