Will I Get Better Results From Adding Botox 2 Weeks After Initial Injection?

I am from Russia, and here doctors recommend to "add" Botox in around 2 weeks time after first injection if necessary effect was not reached. Is it true? Because antibodies still can get produced already, and "adding" won't work. Is it better wait 3 month and then do injection again?

Doctor Answers 11

Botox touch up

Hi Catherine,

I agree with the other physicians that it is prudent to see patients a few weeks after their first Botox/Dysport injection.  Every patient responds a little differently to the products.  If the results are satisfactory, then the locations and amounts for each injection site are documented and can be reproduced for the following sessions (thereby obviating the need for follow up visits after each treatment in the future).  If a modification is needed, I will incorporate this into future treatment sessions.  In rare cases it takes two, or at most three cycles to narrow down the exact parameters.  I certainly would not advise you to routinely have extra Botox injected as a matter of routine two weeks after every session. 

Yoash R.  Enzer, MD

Providence Oculoplastic Surgeon
3.4 out of 5 stars 8 reviews

Botox touch up at 2 weeks

Generally, a two week followup after your treatment is a good idea to assess your results. At that time, a touchup can be performed and will be effective. 

Once you see your results wearing off, you can have the treatment again. This is generally in about 4 months or so.

Michael Constantin Gartner, DO
Paramus Plastic Surgeon
4.7 out of 5 stars 137 reviews

Adding botox units a couple of weeks later is OK

There has been no clinical evidence that adding botox a couple of weeks later stimulates antibody production when the number of units is low such as in cosmetic facial treatment. It is better to add then to initially place too much.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Botox "touch-ups"

2-3 weeks is the ideal time to add any additional botox in the area treated if you and your treating physician thinks there is room for further improvement or relaxation. This is very unlikely to lead to antibodies against botulinum.

Elizabeth F. Rostan, MD
Charlotte Dermatologist
4.2 out of 5 stars 19 reviews

Botox results are seen by 10-14 days after injection

If at that point more Botox is needed to achieve the clinical result you wish, more can be added.  I would not add more Botox before those two weeks as the end result may not be seen and you may get an over-correction.

The risk of developing antibodies to small doses of Botox required for cosmetic procedures are very small to begin with and will not be changed much by injecting a few more units two weeks after the initial injection.

Emily Altman, MD
Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Follow up Botox treatment at 1 month after initial Botox Injection

I have used Botox for over 20 years and feel that I get the best results when treating Botox patients with a full dose booster at 1 month after their initial Botox treatment...then every ~ 6 months thereafter.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

When First Trying Botox it is Safer to Start Low

For my first time Botox patients I frequently start them on the lower side of the normal dosage range unless it looks like they have really strong muscles in the area. That way they do not run the risk of either being overdosed with Botox or being overly sensitive to it and not liking the result. I tell every new patient to let me know after two weeks if additional Botox is required and we do a touch-up if necessary. Then we know for the next time what the correct dose will be.


Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Botox Results Should be Assessed by Your Doctor in 2 Weeks

I ask all of my patients to return for a follow-up, 2 weeks after their first Botox treatment.  In this way, I can assess whether the amounts of Botox used were appropriate and in the right locations. Since these parameters vary from person to person, the only way to know whether the treatment yielded perfect results is to check two weeks later, once the effect has occurred. If a touch up is required, for one reason or another, it is my pleasure to add further Botox to the treatment sites at no expense for the touch-up.  We now know the precise amounts and locations that will be required at the time of the next Botox treatment in 3-4 months.

Sheldon Pollack, MD
Toronto Dermatologic Surgeon
5.0 out of 5 stars 1 review

Sure a touch up is reasonable.

My real opinion is that an expert BOTOX injector should be able to tell you in advance with great precision how much BOTOX you need.  This avoids this appointment after the fact.  However, there is no reason you can't add additional BOTOX after the fact to make up for an inadequate dose of BOTOX from the initial treatment.

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

When to get a Botox touch up

Botox touch up can be helpful if the optimal results are not obtained on the first injection.  If a patient is having a Botox or Dysport treatment for the first time, I like to schedule a follow up appointment in 2 weeks to make sure that things look great. If any irregularities are noted early after injection, it is a good idea to wait at least 2 weeks before a touch up, because sometimes it takes that long for the full effects of the first treatment.   At that time if any area has been under-treated, then a quick touch up will usually ensure excellent results.   

Once the appropriate dosage has been found for an individual, a separate touch up appointment is usually not necessary.  However, if any asymmetries occur or other concerns arise, a follow up visit with your facial plastic surgeon is a great idea.

Antibody production to the Botox is possible, but this is thankfully very rare.  A touch up injection should not put you at higher risk for antibody production.

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