is my Botox unevenly distributed? Was is too diluted? The right side of my forehead protrudes while the left side is flat! (phot

I had 18 units to my forehead. 12 to my glabella and 10 to each crows feet for a total of twenty in the eyes. This was five days ago. My forehead still moves way to much and the right side protrudes or feels swollen compared to the left side. Help! How do I get the spa to fix this? It feels like there is a lump there when I move my forehead. I just noticed this after my last question l. I'm very worried.

Doctor Answers 13

Botox Longer


Thank you for your question.

Botox usually takes 2 or 3 days to start to work, and will continue to improve over the first 7 to 10 days. The full affect is typically achieved after 14 days.

Should you still have full movement after 14 days, I'd recommend booking a follow-up appointment with your qualified injector to discuss your concerns and options.

Take care.

Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

For now, wait

It can take up to two weeks for your final results. For now, wait. If you still aren't happy at the two week mark, speak with your surgeon. Best, Dr. Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Botox Results

It takes 10-14 days for the botox to take effect, I suggest waiting to see the ultimate results.  The dosing you had is little low on the glabella and eyes but high on the forehead.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Botox Asymmetry

Five days is usually not enough time to see the complete effects of the Botox and it is common for the medication to set in asymmetrically.  I offer all Botox patients a follow up in two weeks to examine for any asymmetry or areas of persistent muscle activity that needs to be corrected.  Especially if I am injecting someone for the first time, I would rather be conservative in my injection. 18 units for a full forehead is usually adequate dosing.  With time, your forehead may correct itself.  If not, definitely return to the provider who injected you for correction.  In the future, I would recommend seeing a board certified plastic surgeon to be confident in their experience and training.  

Brian A. Pinsky, MD
Long Island Plastic Surgeon
5.0 out of 5 stars 6 reviews

Botox to the Forehead

Five days after treatment you are beginning to see the effects of the botox injection and its onset is probably not occurring evenly.  Wait another several days and I'm hopeful that all will improve.  18 units to your forehead sounds prudent and reasonable with max benefit appearing by day 14.   At that point if there is any distortion or asymmetry return to the clinic for a supplement. 

The swelling that you mention is probably only a bruise from the injection and should resolve.  I advise my patients to avoid any blood thinning medicines like aspirin and motrin for 10 days pre treatment and I apply ice compresses right before and after the injection.

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Forehead botox

First, I would give it a week to ten days before considering anything as a touch up.  You may need more, but I can't really tell from the photo since it blocks part of your face.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Botox for the forehead

It can take ten to fourteen days to see the full effect of your Botox treatment.  If you are still not happy at that time, you should return to the "spa" for assessment.  Hopefully, an experienced doctor treated you and will know how to adjust your treatment.  If you did not have treatment with a doctor, consider doing so next time.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

Five days too soon to judge

The Botox effect develops over 10-12 days. You need more time before you can judge the effects. Those units may be ok for you after the full effect has developed. If not, return to your injector. Everyone is different and so the Botox needs to be customized for your face. After the full effect occurs, your injector can decide if you need more or less or a different pattern.

Jeffrey Schiller, MD
Edison Oculoplastic Surgeon
5.0 out of 5 stars 11 reviews

Problem with Botox Injection

The 18 Units of Botox to the forehead should be enough to completely paralize the entire forehead. Unfortunately, it appears as if all the Botox was placed in 2 areas and the majoritity of the forehead (frontalis muscle) still works. I cannot tell anything else because of the poor quality of the picture.) The normal thing to do would be to retuern to the physician who did the initial injections. Unfortunately, this may not be possible in your case because of the poor choice of entrusting your face to a spa rather than a fully qualified and experienced physician (see If the physician who is supposed to be overseeing the spa cannot see you or is not a board certified plastic surgeon, dermatologist or ENT with significant training and experience in injectables, your best option would be to find one of the Core specialty physicians with these qualifications.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Uneven result from Botox

It seems that your botox is working well in the areas in which they placed it but it appears that the administration resulted in some irregular results.

I'd suggest you return to your practitioner and ask them for help. They should be willing to assist you.

Adding botox should be able to help smooth out some of the irregular results.

If you're not confident in the practitioner, you could seek out another specialist in your area and preferably a Physician who performs regular botox themselves.

I hope this was helpful.

Adam Scheiner, MD
Tampa Oculoplastic Surgeon
4.4 out of 5 stars 37 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.