Why is my Forehead Still Wrinkly 2 Weeks After Botox? (photo)

Two weeks ago I had 90 units of Botox to the forehead, crows feet and elevens, administer by My kids Orthodontist. I new I should have run out of there. Two weeks later my forehead is still totally mobile. I have had botox 4 times before from my dermatologist at 35 units it lasted super long 9 months at a time and I loved the results which I saw in 7 days When I emailed my dissatisfaction , sarcastically saying my whole face should be frozen, the Dr is all insulted, I'm choked this cost $950 ,

Doctor Answers 13

Orthodontist and Botox Injections? There's Your Trouble

The statement that you allowed your child's Orthodontist perform Botox on you brings to mind the song by the Dixie Chicks, "There's Your Trouble".  I have never attempted to place braces on a child despite the fact that this might be a lucrative avenue, and an Orthodontist has no business or excuses for injecting Botox. This result after 90 units of Botox is inexplicable in trained hands. 

Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 95 reviews

Unhappy with Botox treatment

I won't chastise you, but really, an orthodontist? Normal full injections of Botox to treat the 11s, forehead, and crow's feet is about 50 units. And you had 90. I've never injected a person with 90 units of Botox to treat those areas, and I've been injecting Botox for over 20 years. I don't think you had a good treatment, quite frankly, and cannot see why you would have received 90 units. Your question is why it's still wrinkly and my guess is that your injector was inexperienced and the Botox may have been diluted more than recommended. If you'd done Botox before and gotten 35 units and were happy, why go somewhere else and get almost 3x the amount and pay that much? Next time, don't do your treatments there, and return to the injector who made you happy before.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

90 units of botox by an orthodontist!!

I dont know where to begin. 90 units of Botox or orthodontist doing botox or why would u do that to yourself??? anyhow, whats done is done. 90 units of botox or Dysport or Xeomin would freeze the entire upper third of the face and will leave u with droopy eyes and inability to raise your eye brows, your forehead, your frown all those movements should be paralyzed. the only time Ive ever used more than 50 units on a patient is when Im injecting it for excessive sweating in palms and feet. this is too much Botox, injected in the wrong places by wrong hands. just wait it out and once its completely gone find your self a plastic surgeon or a cosmetic dermatologist and get it done right. u will love it!

Misbah Khan MD, FAAD, FACMS
New York Dermatologic Surgeon
4.9 out of 5 stars 28 reviews

Botox by an orthodontist

Would you let me put braces on your teeth?  Seriously!  In NY, it is actually illegal for dentists to inject Botox and fillers because this constitutes the practice of medicine.  Clearly, this is outside the scope of dentistry.  I recommend that you see a board certified dermatologist or plastic surgeon.   This will now be an uncomfortable situation when your children return to the orthodontist for followup.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

Botox by Dentists is unwise

Ninety units of Botox to the forehead should completely paralyze this region.  This is an excessive amount of Botox for any area.  I would recommend you not have Botox by your dentist in the future.  Specialties that are qualified to inject Botox are Dermatology, Facial Plastic and Reconstructive Surgery, Cosmetic Surgery, Otolaryngology and General Plastic Surgery.  I would caution you against injections from any other medical or dental specialty.  Good luck to you in the future.  Warmest regards.

Dr. Pippin

Gregory Pippin, MD
Metairie Facial Plastic Surgeon
4.2 out of 5 stars 7 reviews

Dr. Prendiville is spot on here.

Properly done, 90 units of BOTOX would freeze your forehead.  Very few people need this type of treatment.  You need to find the right doctor.  Perhaps you should go back to your dermatologist.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Bad Botox

Dr. Prendiville's answer made me laugh.  I've never head of anyone getting 90 units of botox in their forehead.  I don't think I've even ever injected 90 units of Dysport (which takes 3 times as many units typically) in the forehead and the glabella (between the brows) combined.  I typically inject 15 units in the glabella and at the most 12 units in the upper forehead.  This works for the vast, vast majority of patients.  This is a live and learn situation. 

Matthew Bridges, MD
Richmond Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Forehead Botox

90 units in the frontalis muscle (forehead) is excessive.  The fact that an orthodontist injected it is.....well, I'm not really sure what to say about that.  I'm sure that if a cosmetic surgeon placed braces on someone they would use too much "glue", charge way too much, and get a very poor outcome.  Same thing happens when an orthodontist tries to inject Botox.

Clyde Mathison, MD
Knoxville Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Forehead Botox administered by a dentist

It is scary that you would allow an Orthodontist to inject anything outside of your mouth. Would you let your plumber do your taxes?  Who knows what you had injected, and its doubtful they would have the knowledge of symmetry, beauty and anatomy that a highly trained skin expert such as a dermatologist would have ; oh well, you get what you pay for. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.8 out of 5 stars 53 reviews

Continued Wrinkles 2 Weeks after Botox


If you liked the results you received from your dermatologist who administered 35 units, than that is the ideal strategy for you. 90 units is too much for the forehead area. As Dr. Rueckyl mentioned, the reason you are still noticing mobility and the persistence of wrinkles in the forehead, may be due to the overdilution of the Botox solution. Also Botox needs to be kept cold during the transport between the manufacturer and the clinic. When it arrives, it must be promptly refrigerated, otherwise the whole batch will be spoiled. I would recommend that you seek the help of a board certified dermatologist as opposed to an orthodontist for future Botox treatments. 

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 32 reviews

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