Can botox spread to your vital organs? Is 45 units a lot for your first time? (photos)

I've had a consultation and booked my appointment for next week. It's my first time having botox and it's been recommended I have 45 units for the areas of my forhead, frown lines and the area under my eye just over my checks, I sleep on my side and end up with creases in this area as a result. 45 units seems a lot to me for my first time. Is it to much? I'm also very nervous I might have a bad reaction, I quite scared even thinking about the procedure, is it possible for botox to travel to vital organs?

Doctor Answers 10

Botox dose

45 units is not an unreasonable dose for all of those areas.  If it's your first time, it may be ok to use a smaller dose to begin and then add more as needed.  But botox will not travel to vital organs when used appropriately for cosmetic use.


San Diego Physician

Botox dose and spread

Thank you for your question mariama3. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. 45 units is not a high dose, some people have over 100 units in a single treatment and when used for neurological purposes over 300 units may be performed at a given session. Such small doses are used for the small muscles in the face. To affect muscles associated with breathing much higher doses (100 times or more) are likely required. Further there is minimal absorption of Botox into the blood stream and I advise my patients not to worry about these things. Please consult with a doctor for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 1 review

Botox safety

I think 45 units is very reasonable for the treatment areas you described. To put it in perspective, studies show the maximum recommended dose per session is around 600 units. The toxic dose is in the 3000 unit range. You are quite safe at 45 units with no risk to vital organs. 

Matthew Brace, MD
Ontario Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Botox treatment - dosing and safety

I often tell patients that Botox is one of the safest procedures I perform in my clinic. Botox is an FDA approved treatment with years of clinic research and data supporting its safety. I would not be worried. The dosing of 45 units seems about right for the 3 areas you are having treated. 

Botox and Vital Organs

Botox is safe and when injected only works locally, it doesn't get absorbed in the body.  45 units depends on the places injected and seems normal for brow, forehead, and eyes -- maybe even low.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 167 reviews

Can 45 units of Botox spread to my vital organs?

This is proper dosing for the areas you are getting treated. The Botox can spread by about a centimeter from it injection site. It will not go to your vital organs. There should be no worry about that at all. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Vital organs.

Botox and Dysport are safe and FDA approved with long records of great results. In our office, we have injected over a thousand patients with good results. I do not believe 45 units is too much and is what I would routinely use to treat the frown lines and forehead wrinkles. Make sure you're using a certified injector. Best of luck, Dr. ALDO :)

Aldo Guerra, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 190 reviews

Botox spreading to organs?

Hi mariama3. Great question. Botox is one of the most popular aesthetic procedure in the world. There is a reason so many people want it.... it works!! 45 units is not a big deal depending on where it is needed. I sometimes use more than 45units on some patients. Botox will not get into your organs. It is injected too close to the skin to go that deep into your organs. Don't worry. However I must say you need to do your due diligence and make sure you have vetted this doctor. Make sure he or she has done many injections. Complications from Botox do exsist and you must have the doctor explain theses before your injection. Being a first timer I understand your apprehension, but if done properly you might just become addicted!!.  Cheers. 

Shoib Myint, DO, FAACS, FAOCO
Henderson Ophthalmologist

Botox doesn't spread to vital organs

Given your overall apprehension and statements like "I might have a bad reaction", I strongly advise you against having this elective cosmetic procedure. No one NEEDS Botox especially if it makes them this nervous.

Edwin Ishoo, MD
Cambridge Facial Plastic Surgeon
4.4 out of 5 stars 20 reviews

Concerns about botox

Your concerns about botox having serious medical side effects is very common.  Fortunately, at the doses used for facial treatments, botox is very safe.  The most common side effects are actually confined to the treatment area and these can include drooping of the eyebrows, asymmetry or bruising.  45 units is not too much for a first treatment depending on your areas of concern and the extent of your wrinkling.  If you remain afraid that it's too much, simply ask your doctor to use less for the first treatment.  You can always add more later.

Brett J. Snyder, MD
Jacksonville Plastic Surgeon
5.0 out of 5 stars 4 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.