I had 52 units of Botox and three days later I still have full movement. What do you think is happening?

I am not sure if you had only the horizontal lines of your forehead treated with Botox or also your frown lines (the vertical lines between the eyebrows).  If you had both the forehead and frown lines treated, I would consider 44 units an average dose.  I understand you went back 2 weeks later and had an additional 52 units placed and feel you still have movement after 3 days.  I normally tell my patients to wait at least 2 weeks to see the full effect from a Botox treatment, so it is likely that you have not seen the results of your second treatment at 3 days afterwards.  I would recommend waiting 1-2 weeks to see your results from that second treatment.  

I can understand your concern and sounds like an excessive amount of units for the forhead “only” treatment. Even though its usually not the case but can happen when a client is resistant to Botox and/or wonder if properly injected. You could always try Dysport or Xeomin. Both are neurotoxins similar to Botox but spreads differently and not as easily motabolized, causing the product to last longer for many clients.Hope this helps! 

Botox results take up to 1-2 weeks and last up to 3-4 months in new areas of treatment. I recommend getting a formal evaluation with a cosmetic dermatologist. Dr. Emer

Sorry to hear that. So overall that is lot of botox for the 2 areas and if there is no relaxation of the muscle then the issue could be the botox itself or very rarely soem people are just immune to botox but that happens on subsequent treatments not on first. I would go back to the injector and discuss. I will some times switch to other neurotoxin and see if that works. 

It is highly improbable that you have "resistance" to botox. That is a heap of Botox. Your forehead should be stone cold frozen. I am not saying that is what one should seek with a Botox treatment. I suspect that it is time to look for a new injector. It is cheaper to sell salt water than Botox. Unfortunately that creates the temptation to provide less Botox than you bargain for as a way of increasing profit. If you conclude that might be the basis for why you are not getting the result you are looking for, I recommend looking for an ethical injector. 

It can take up to two weeks to see your final result from Botox, so you will want to wait a bit longer. If you still have full movement you may want to discuss potential issues with your injector. Was the Botox fresh? Is your injector experienced? You may want to try a different injector or even a different neuromodulator such as Dysport.

Thank you for your question.  Depending on the strength of your muscles and the placement of your forehead lines, 44 units of Botox should be a good amount to treat your area.  However, if you have been injected 3 days ago, I would wait about 2 weeks to see if the second injection will address your issues.  It takes about 2 weeks for Botox to full bind with your nerve receptor sites.  I have seen 2 patients, in over 10 years of injecting, who have developed antibodies to the protein molecule and Botox was no longer effective.  These were women who had been treated for decades.  I hope that helps answer your question.

There are several reasons why the botox may not have worked - product may be old, product may be diluted or you could have developed resistance to the product 

Thank you for your question tamaramargolis. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.
It is difficult to make an assessment in the absence of consistent photographs before and after in the same lighting and angles for comparison and without knowing the exact placement of the product. However, I hope the information provided here is useful.The appearance of frown lines is variable from person to person. Usually they are in a vertical orientation but sometimes they can be oblique and sometimes a horizontal line is seen across the upper portion of the nasal bridge. The most common variation is to have two parallel lines, hence the common term "11's" to describe them. But some people have one, three, or more lines. Some people also will see a bulge in the area when contracting the muscle. This bulge is smoothened out after a Botox treatment.
The pivotal studies used 20 units of Botox in the glabella area between the brow to address the frown lines, 24 units of Botox (12 units per side) to address the crow’s feet, and 20 units of Botox in the forehead area above the brows to address the horizontal lines seen when one raises the brows. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary. Although 20 units is a good standard dose to start with in the glabella, some people require a higher dose because of higher muscle volume. This is common in mature patients, in those with large bulges from expressive faces, and in men. I find that Botox still works in these cases, just a higher dose is required. I have used up to 40 units in the glabella.
The pivotal studies for the horizontal lines on the upper forehead were published many years after doctors had been using Botox. In these studies, 20 units of Botox were used to treat this area. However, in my experience I find that anywhere from 10 to 20 units works well in this area. For patients with narrow foreheads a lower dose may be used and those with a broad forehead generally require higher doses. I have also found that the full results in this area are seen by two weeks. Therefore, we have our patients return two weeks after their treatment to assess the results via photographs. At that point additional units may be used if further enhancement is desired.
When patients present with concerns about specific wrinkles in the upper face such as the frown lines, I always assess and usually treat the other wrinkles in the upper face including the horizontal forehead wrinkles and crow’s feet. The reason is to maintain a harmonious and natural balance to the appearance of the upper face. The muscles in the glabella which are responsible for the formation of the frown lines serve to pull down on the inner brows when a person frowns. Similarly, the muscles around the eyes which are responsible for the formation of the crow’s feet seen when smiling (orbicularis oculi) are also responsible for pulling down on the brows, but in this case the outer brows. On the other hand, the muscle in the upper forehead which is responsible for the formation of the horizontal forehead wrinkles when a person raises the brows (frontalis) serves to pull the brows upward. If one of these muscles is relaxed with Botox and the others are not, the other muscles will still be active. This will lead to an unbalanced and unnatural appearance of the upper face where the brow can be elevated, depressed, or uneven in shape or position. Therefore, I recommend that my patients take a global approach to the upper face when receiving Botox treatments and treat all three of these areas. Sometimes bunny lines on the bridge of the nose are also treated.
If I had a patient with the concern described here I would recommend waiting two weeks after the second treatment and returning to the injector at that time for an assessment.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!

Hi,
The amount of Botox used on your forehead the first time seems an average amount and is totally fine.  Some patients require more which is why we ask patients to return at the 2 week mark for a touchup as two weeks is when you really notice the effects of the product.  52 additional units should get you to your goal, but again, you need to wait the full 2 weeks after the injection to appreciate the results.  Be patient as the product works.  If you still have full movement at 2 weeks from your second injection, you should be r-evaluated.
Best,
Dr. Tanya Judge