I am trying to get rid of my 11s between my eyebrows. So far I have recieved 50 botox units. 20, then 15 and 15. all a week apart. Things have softened but still have quite a bit of movement. Dr. just keeps telling me that I have strong muscles and havent met my theshold yet. At what point do I just give up? how much is too much?
Answer: Inadequate response from Botox - causes
There are several causes of your problem.
First, your corrugator muscles are broad based, i.e. .completely over the eyebrow, so those fibers will need to be relaxed as well.
Second, the wrinkles you have are very well established and it will take some filling material to fill in the wrinkle in the mean time. Patient expect the "11's" to be gone, but Botox will not always eliminatedecades of sun damage and wrinkling.
Third, you are actually refractory to Botox, rare but possible.
Helpful 2 people found this helpful
Answer: Inadequate response from Botox - causes
There are several causes of your problem.
First, your corrugator muscles are broad based, i.e. .completely over the eyebrow, so those fibers will need to be relaxed as well.
Second, the wrinkles you have are very well established and it will take some filling material to fill in the wrinkle in the mean time. Patient expect the "11's" to be gone, but Botox will not always eliminatedecades of sun damage and wrinkling.
Third, you are actually refractory to Botox, rare but possible.
Helpful 2 people found this helpful
Answer: Botox Responsiveness
A dose of 50 units of Botox (Allergan produced) in the glabella should have some degree of efficacy as far as minimization of movement (assuming that you are receiving the real product, properly reconstituted, and properly administered). Please understand that very deeply etched lines will not disappear with Botox alone. However, I have seen an occasional patient who is poorly responsive to Botox, yet responds to Dysport (Medicis produced).
Helpful
Answer: Botox Responsiveness
A dose of 50 units of Botox (Allergan produced) in the glabella should have some degree of efficacy as far as minimization of movement (assuming that you are receiving the real product, properly reconstituted, and properly administered). Please understand that very deeply etched lines will not disappear with Botox alone. However, I have seen an occasional patient who is poorly responsive to Botox, yet responds to Dysport (Medicis produced).
Helpful
September 1, 2015
Answer: Botox for the glabellar "11s"
You state that you have had weekly additions to the botox number of units in the glabella. During an examination for this concern, I evaluate if the muscles are moving, not if the creases are still there! If you are not able to move the muscle then you need no more Botox for now. There may be continued improvement of the creases as time progresses and the muscle is no longer able to make the skin fold like an accordion. YOu have probably develoepd these creases from years of crinkling the frown muscles and for some patients, the creaes are deep and need many months of muscle relaxation for the lines to improve. Sometimes botox takes more than two weeks to show its maximal onset of effectiveness and it may be unwise to add units before this time. If two weeks after Botox the muscles are still moving then additional units may be needed, and for some hypertrophic muscles, mostly in men, but I have seen some women with this as well, 50 to 60 units are needed, but not much more, and again, this is not common. If the muscles are relaxed, and you don't want to wait months for continued improvement then a filler can be added but it should only be Juvederm Ultra or Restylane. Thicker products have compromised circulation in this area and caused complications.
Helpful
September 1, 2015
Answer: Botox for the glabellar "11s"
You state that you have had weekly additions to the botox number of units in the glabella. During an examination for this concern, I evaluate if the muscles are moving, not if the creases are still there! If you are not able to move the muscle then you need no more Botox for now. There may be continued improvement of the creases as time progresses and the muscle is no longer able to make the skin fold like an accordion. YOu have probably develoepd these creases from years of crinkling the frown muscles and for some patients, the creaes are deep and need many months of muscle relaxation for the lines to improve. Sometimes botox takes more than two weeks to show its maximal onset of effectiveness and it may be unwise to add units before this time. If two weeks after Botox the muscles are still moving then additional units may be needed, and for some hypertrophic muscles, mostly in men, but I have seen some women with this as well, 50 to 60 units are needed, but not much more, and again, this is not common. If the muscles are relaxed, and you don't want to wait months for continued improvement then a filler can be added but it should only be Juvederm Ultra or Restylane. Thicker products have compromised circulation in this area and caused complications.
Helpful
March 29, 2011
Answer: For 11's dual therapy with Botox and Fillers.
I like to "nuke" the 11's for a new patient. Using a HA filler like Juvederm or Restylane along with the Botox can give you a running start. Fillers work for a long time when done in concert with Botox, because the muscular action isn't "milking" the filler out of the area. Unit wise, 20 plus 15 plus 10 sounds like a lot. Watch your brow position, as extravisated Botox can cause problems in adjacent muscles!
Helpful
March 29, 2011
Answer: For 11's dual therapy with Botox and Fillers.
I like to "nuke" the 11's for a new patient. Using a HA filler like Juvederm or Restylane along with the Botox can give you a running start. Fillers work for a long time when done in concert with Botox, because the muscular action isn't "milking" the filler out of the area. Unit wise, 20 plus 15 plus 10 sounds like a lot. Watch your brow position, as extravisated Botox can cause problems in adjacent muscles!
Helpful
March 25, 2011
Answer: Maximum Amount of Botox for Frown Line?
Hi Avion. It sounds like you have more than enough to relax the muscles in this area. Even if you had extremely developed muscles, 50 units is a lot and should have done the trick.
If you cannot animate (move or contract) the muscles that cause the frown, then you do not need more Botox and your injector needs to think more about a dermal filler like Restylane. If you are not able to move the muscles and your injector has not already suggested a dermal filler like Restylane, then you may need to start looking for a new injector as this is a fairly common issue.
Helpful
March 25, 2011
Answer: Maximum Amount of Botox for Frown Line?
Hi Avion. It sounds like you have more than enough to relax the muscles in this area. Even if you had extremely developed muscles, 50 units is a lot and should have done the trick.
If you cannot animate (move or contract) the muscles that cause the frown, then you do not need more Botox and your injector needs to think more about a dermal filler like Restylane. If you are not able to move the muscles and your injector has not already suggested a dermal filler like Restylane, then you may need to start looking for a new injector as this is a fairly common issue.
Helpful
March 23, 2011
Answer: Botox touch ups should be 2 weeks apart
You might need more Botox if you are a man. Some men need up to 60 units in the glabellar ("11") area between the eyebrows. But, you mentioned your touch-ups were only 1 week apart and it can sometimes take up to 2 weeks for all of the effect to "kick in". So if you just had your 2nd touch up you need to wait 2 weeks afterwards to see the full effect. That being said, if you can't move it at all but see furrows you might need some filler, such as Juvederm or Restylane, in that area in addtion to the Botox. In my practice 95% of my patients with lines in that area can get complete smoothing with just Botox but that other 5% also needs a filler.
You also would want to see if you got Botox Cosmetic vs. Dysport. Dysport is a botulinum toxin that is measured differently and 50 units of that equals only 16- 20 units of Botox Cosmetic.
Helpful
March 23, 2011
Answer: Botox touch ups should be 2 weeks apart
You might need more Botox if you are a man. Some men need up to 60 units in the glabellar ("11") area between the eyebrows. But, you mentioned your touch-ups were only 1 week apart and it can sometimes take up to 2 weeks for all of the effect to "kick in". So if you just had your 2nd touch up you need to wait 2 weeks afterwards to see the full effect. That being said, if you can't move it at all but see furrows you might need some filler, such as Juvederm or Restylane, in that area in addtion to the Botox. In my practice 95% of my patients with lines in that area can get complete smoothing with just Botox but that other 5% also needs a filler.
You also would want to see if you got Botox Cosmetic vs. Dysport. Dysport is a botulinum toxin that is measured differently and 50 units of that equals only 16- 20 units of Botox Cosmetic.
Helpful