I received my first Botox yesterday. I was given 15 units in my forehead. Any suggestions?

Muscles injected with Botox can no longer contract and this causes the muscles to relax. When the muscles relax, the wrinkles in the skin overlying the muscle begin to soften. The goal of Botox, therefore, is often two-fold:1) To help soften wrinkles that are already present2) Prevent the formation of new wrinklesThe dosing for Botox to achieve these goals is variable and based on the desired effect, the amount of current animation, and the strength of the muscles.  Some rough guidelines are:



Forehead: 16 unitsCrowfeet: 8 units per sideGlabella: 18 units



The glabella often requires as much or more than the forehead due to the number of muscles and the strength of the muscles in this area. For new patients, however, the exact dosing is often discovered through a trial and error process. See link below.A conservative starting dose of 10 units is reasonable for the glabella, however, additional Botox may be needed at a
later visit to achieve full effect. Consultation with a surgeon certified by the American Board of Plastic Surgery would be the next best step.

I rarely do the forehead without doing the 11 lines.  If you do that you have the potential to cause eyebrow ptosis (lowering).  With that said, 15 units is also a lot for a forehead depending on how large.  Normal dosing for 11 lines is 16-24 units.  However, all units should be tailored to the individual persons anatomy and movement.  I suggest going to an expert injector.  Best, Dr. Emer.

Botox dosing varies from person to person and based on injection technique.  However, too many physicians rely upon a flow chart of cookbook mentality when it comes to treating patients.  All patients are different and should be treated as such.  This may or may not be the issue in this case.  20 units is not a large dose for the "elevens" or glabella and would generally be about right in this area starting out.  15 units would be considered a higher dose in the forehead, especially in a first time patient.   I recommend always seeking out an expert injector and having a frank conversation about expectations of results / cost.  For first time patients, it is a good idea to have a follow up in 10-14 days to evaluate effects.

Thank you for sharing your question. Botox injections are very effective for wrinkle reduction in the forhead, crows feet region and between the eyebrows. For deep lines, more Botox is required. Typically, women require a little less product to be injected in order to have similar effects to men. Being cautious by injecting slightly less is acceptable. Injecting an excessive amount is not prudent and is potentially harmful. Make sure your doctor is experienced. Good luck.

Thank you or your question. Each area of the face requires a different dosage to obtain the desired result, depending on the strength of the muscle and anatomy of the face. Perhaps seek more information regarding your face specifically from a consultation. Best, 

Everyone's facial muscles are different. Therefore, everyone's Botox treatment should be different. Using 20 units in the 11 lines is pretty typical for that location, but if you don't have any lines there yet, and want to "low dose" the area just for prevention, I think that would be very appropriate. We have many patients that we use lower doses of Botox as a preventive treatment.Regarding your forehead, using 15 units may be an appropriate dose depending on the activity of the frontalis muscle and it's size. Again, every Botox treatment should be customized. We want to relax the forehead muscles, but we don't want to completely relax those muscles to the point where you can't move your brows at all, so it depends on your anatomy as to how many units that would require. Sometimes we will use a lower dose for the first treatment to see if that's enough, and we might use more the second time if necessary.Make sure you see an injector with extensive experience. An inexperienced injector can be a real inconvenience if you don't get the result you desire.Andrew Campbell, M.D.Facial Plastic SpecialistQuintessa Aesthetic Centers

Botox can be used to prevent developing lines and wrinkles in the face like the vertical lines between the eyebrows (glabella region).The average standard Botox dose to treat vertical lines between the eyebrows (11's) is 10 units. In some patients with strong muscles like men, italian background female patients, etc, a higher dose might be necessary (usually 15 units). In very rare cases 20 units might be necessary.For prevention of vertical lines formation between the eyebrows in patients that are not even seen in animation, a low dose of 5 units in very long patients or 10 units could be sufficient. In my practice, 5 units of diluted Botox gives me similar effect than 10 units concentrated botox in the glabella region, thus effective and economical for patient candidates.Botox dosage for treatment and prevention of lines and wrinkles varies greatly among patients and should be customized to the specific patient needs.  

Thank you for your question.  Without a series of photographs, or an in-person evaluation, it is difficult to determine appropriate Botox dosing as each physician bases their injections on several variables, including the area, degree of wrinkling, size of muscle being injected, etc.  Voice your concerns with your injector, they should be able to better explain the rationale for their dosing.  Hope that this helps.

The amount of Botox required depends on the strength of the muscles and the area being treated.  It can take up to two weeks to see the full result.  Some patients will have some lowering of their brows with the forehead injections so your doctor may have thought that treating the area of your 11 lines would help lift your eyebrows. See him in two weeks for assessment.

Muscle size for the frown muscle is such that one would not see much change with 10 units of Botox.  Your injector was giving you the right expectation.