I got 20 units of botox injected into my forehead because of wrinkles there especially the for head. Any suggestion?

After a couple weeks nothing changed. I want to try again. How much should I get this second time around??? I was thinking 30-40. The wrinkles are very large but not too deep. When I raise my eyebrows it is like an accordion.

Doctor Answers 12

Botox dosing

There are numerous factors that come into play when determining botox treatment. This includes total dosing in units, reconstitution (how is the botox mixed), placement of injections, severity of wrinkles, etc. Injection of large doses of botox into forehead can cause extensive sensation of heaviness and even brow droopiness (brow ptosis) which is not recommended. You should see an expert injector who can determine why your previous botox did not work. Alternatively, trying a different preparation, such as dysport could be a solution to your concern and you should see visible results much faster, typically within 3-5 days. 

Calgary Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

I got 20 units of botox injected into my forehead because of wrinkles there especially the for head. Any suggestion?

Thank you for sharing your question. Unfortunately without an in-person examination it is difficult to offer definite advice but you should have seen some improvement in your wrinkle appearance with 20 units of Botox and I would voice your concerns with your injector.  You may require additional units but ensure that your injector has the experience to appropriately treat your forehead areas of concern.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 68 reviews

Botox forehead...

Thank you for your question.  You may require additional Botox, although typically it does not require more than 20 units to treat the forehead.  It is best for you to speak with your board certified Dermatologist/PS who injected you and discuss your concerns so that they may touch up the area.  Please make sure the Botox was fresh, diluted correctly and is genuine Botox.  Regards, Dr. Matt Elias

Matthew Elias, DO, FAAD
Fort Lauderdale Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

Botox results

I would strongly recommend going back to the same person who injected you the first time so that they can tell you what they think is going on.  Botox can have variable effects at times for any number of reasons but on the whole, 20 units of botox would be expected to yield some results.  However, sometimes it takes a couple of weeks to see the full effects and I would encourage you to wait at least 14 days before deciding anything.  Your injector should have taken before and after pictures and you can then discuss what is going on in your specific situation.  I would also urge you to have botox done by an expert in injection, usually a board certified dermatologist or plastic surgeon.  
When trying to decide what to do next, I would ask your injector for your options.  Generally speaking, you could have more botox injected the next time.  Most importantly, the question would be where the injections were done on your forehead.  Often times the forehead and glabella are treated at the same time and if that is the case, 20 units may not be enough for you to treat both areas.

Hooman Khorasani, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 30 reviews

Botox for forehead

Hello, and thanks for your question. I'm sorry you did not get the result you had hoped for. It is very strange that you would not see any results with 20 units in the forehead, as this is a rather large dose. I suggest following up with your physician to determine ho best to proceed. In order to determine the best treatment plan for you, I recommend an in-person consultation with an expert. Best of luck, Dr. Frucht.   

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Forehead wrinkles

The amount of Botox should have been sufficient and I would not have another 40 units injected. Please consult a board certified dermatologist with experience in Botox for the best cosmetic results. Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 78 reviews

Botox dosage

Without seeing you in person it is difficult to say.  It is best to see an experienced provider who can assess you and determine the amount you need.  It's better to add than have too much.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 469 reviews

Botox for forehead

20 units of Botox may not be enough to adequately treat your forehead wrinkles. The dose of Botox required is directly related to the strength of muscle(s) needing treatment. The stronger the muscle, the more Botox required for correction

Charles Fatseas, MD
Franklin Physician
5.0 out of 5 stars 3 reviews

Botox injection and response

Botox is a medication injected into muscles to selectively weaken them so they pull on the skin less, for fewer/softer wrinkles. 

Typically the medication will take affect in 3-7 days. I like to evaluate my patients at 2 weeks to see the full response before performing a touch-up to undertreated areas. If there is no response, I'll review my records regarding the bottle used for the injection. I always make sure my patients receive authentic product direct from the manufacturer.  Safety comes first. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews


One can not answer y our question without seeing you in person. We don't
know exactly where you were injected and what it would take to make an
improvement without seeing you in person.

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