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

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.

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.

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.

Hi Catherine.  In some cases, a Botox touchup a couple weeks after injection is an excellent idea.  Especially with first time patients, we like to take a little more conservative approach and injecting a bit too little is better than injecting too much.

With these first time patients, we always have them come back after 2 weeks to gauge the results and at that time if more is needed, we add it then.  This gives us a more complete picture of how they respond to their injections and hopefully helps us do a better job.  There is no issue with antibodies!

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.

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.

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.

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.

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

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.