How Many Botox Units for 11's or Frown Lines?

I received 20 units of Botox yesterday. Now I think I may have been cheated, he just wanted to get his $256 and the 20 units he injected were not nearly enough to get "rid" of the moderate/severe "11's" on my forehead. What is the average amount of units needed for this?

Doctor Answers 161

Botox today gone tomorrow.


You seem to have a real distrust for your injecting physician. There is no reason for a practitioner to "cheat" you. The effects of Botox are temporary, lasting only 3 or 4 months, so you will undoubtedly need future treatments. Your injector certainly wants you to be a satisfied customer, to keep you coming back for more treatments. Don't be so skeptical, trust your physician, especially if he/she is a board certified plastic surgeon. Twenty units is a perfectly reasonable amount for your frown line area and may take up to a week to take effect.

Manhattan Plastic Surgeon
4.6 out of 5 stars 48 reviews

Botox takes several days to start working

I can understand your frustration. However, you state that you just had the Botox yesterday. It will take 3 to 7 stays for it to start working and sometimes up to 2 weeks for the final effect. So, please be patient to see the effect.

However, it does usually take between 20 to 30 units for the glabella (your "11's") area. It takes another 15 to 25 units for your forehead and another 2.5 to 5 units for around each eye (crow's feet).

I hope this is helpful.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

How Much Botox for 11's (Frown Lines)

The amount of Botox required for treatment of the 11's depends on the amount of "muscle mass" you have between the brows. It stands to reason that it takes more Botox to treat a larger muscle than a smaller one. I have the patient frown as harshly as possible to determine both the direction of the frown muscles and their relative size. Small frown muscles generally require no more than 20 units. Men and some women with larger muscles may require between 25 and 30 units of Botox.  In some patients, secondary muscles, such as the muscles around the eye, can also contribute to the formation of frown lines. This is often referred to as "recruitment" and can require an additional 10-15 units of Botox.

As mentioned by others, it takes 3-5 days for Botox work in most patients. 

Brock Ridenour, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 119 reviews

One day after injection is not enough time to see Botox results.

If you just received your Botox injection yesterday, you would not expect to see any results yet as it has only been one day since your treatment. To see the effects of the Botox it takes on average 3-5 days from the injection day. The complete results are usually noted at about 7 days.

The average amount of Botox used for the “11” lines between the eyebrows is around 20-25 units for a female. Males will usually require more units as their facial muscles are often thicker and stronger. Ultimately the number of units you need depends on the size and strength of your corrugator muscles.

We tell our patients to call us between 10-14 days if there is any question as to their results. We will then bring them back in for after pictures to compare the results and perform a touch-up procedure if necessary.

Dan Mills, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 33 reviews

Botox injection for forhead

It may take up to two weeks to have the full effect of the Botox on your  frown lines. You will most likely see more improvement

If you can still re-create the lines, all it means is that you either needed more units of Botox injected or you did not have it injected in the right location.

I routinely see patients two weeks post injection to determine if a "touch up" is needed and also to learn how I can do it better for that particular patient the next time.

Best wishes,

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 197 reviews

It depends on the strength of your 11's

The 11's are formed by a muscle called the corrugator that extends, on both sides, from about midbrow to the area between the brows. See link below.

For patients with strong muscles and deep lines, I will use as much as 12 units total for the central part of the corrugator muscles and 8 additional units at the lateral end of the muscle (total of 20 units). I do believe it is important to treat both ends of the muscle to get the best effect.

For a younger patient with weaker muscles and less deep lines, 8 units centrally and 2 units laterally on each side (total of 12 units) is usually sufficient. 

Anand D. Patel, MD
Brookfield Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Botox 25 to 30 Units is Best Frown Line or 11's Treatment

Wait two weeks to evaluate your Botox result. If after two weeks yiou see nothing go back and see your doctor. It takes at least 4 days to see a result after Botox treatment.

I have had many patients respond well to 15-20 Units of Botox. However in patients with thicker skin and large muscle and in patients who have had Botox before I now use 25-30 Units for best effect.


Yesterday? Botox doesn't work that fast!

Botox takes several days to start to kick in and the maximal results are seen in 7-10 days. If you got it yesterday it is waay to early to judge if it is too much or too little. Any effect you see today is probably largely placebo effect.

Chris Thiagarajah, MD
Denver Oculoplastic Surgeon
4.9 out of 5 stars 9 reviews

Too early to judge results

I also use 20 units as a standard treatment for glabellar frown lines ("11's").  It usually takes 3-4 days to see any effect, and 7-10 days to reach maximum.  If, at the end of that time, you have not achieved the results you desire, it may be that your creases are so deep and have been there so long, you may need a small amount of filler (e.g. Juvederm) to finish the job.  It is not uncommon to have to use the two products together.

Robert Stroup, Jr., MD, FACS
Cleveland Plastic Surgeon
4.6 out of 5 stars 19 reviews

Botox does not kick in overnight

Botox takes a few days before you see the effects, so results would not be expected on the day after your injection. It is perfectly normal that you have not noticed anything yet. It usually takes 3 days for the results to appear, and can even take up to 10-14 days to really see the full effect of a particular dose in some patients. That is why touch-ups are not recommended until 2 weeks after the initial injection.

20 units of Botox is a reasonable amount to inject for the glabellar region (space between your eyebrows). Not all patients are the same, so some people need more, and some need less, just based on muscle mass and prior history of Botox. The injections are not placed at random, but into distinct muscles to prevent the lines you describe. The goals are also different for different people. Some want a mild reduction in muscle activity, just enough to keep the wrinkles away, and others want near complete paralysis of those muscles.

If your lines are really deep or severe, Botox may not correct those lines fully, and that does not necessarily mean you got the wrong dose. There is a limit to what Botox can achieve, and deep set wrinkles are not always fully corrected. Even when they do disappear, it will not happen overnight.

The cost of Botox varies significantly depending on where you live. In Los Angeles that price would be considered low, but elsewhere it may the going rate. The cost will also vary depending on who is injecting the Botox. Keep in mind you are not paying for a product. You are paying for a service, and the qualifications, training, and skill of your injector all affect the success of your Botox treatment.

In any case, don't worry just yet. If you are still unhappy two weeks after your treatment, I would recommend a follow-up visit with your plastic surgeon.

Good luck!

Anita Patel, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 12 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.