My Glabella Area Puckers Sometimes on It's Own After 13 Units of Botox, Normal?

I am first time user-I received 10 units of botox in my glabella region 6 weeks ago with an improved appearance after 1 week, then 3 more units 2 weeks later. I never noticed any more improvement and after 6 weeks the botox is gone. When I rub the area (it seems to itch more now), it puckers up before my eyes, then relaxes many seconds later. It's weird & creepy. I see my provider again next week but can't afford more right now. She seemed puzzled on the phone so I don't know what to expect.

Doctor Answers 12

Botox for the glabella may need more than 13 units

Many patients who have glabellar regions of the forehead treated to reduce the frown lines need almost double the units you have had.  This will increase the duration of the effect and improve the smoothness of the result.  Whatever result you have that you don't like now will fade away as the Botox completely wears off; it won't be permanent.  Unfortunately it appears from what you say that you can't afford more units of Botox and if that is the case you shouldn't have the treatment done in the future until you can afford the right number of units that your frown lines would need for a better result.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Botox to the frown crease

It sounds like you only got a paritial correction. 10 units was not enough. I have found you need to start with 20 units for correction in the frown crease.

Esta Kronberg, MD
Houston Dermatologic Surgeon
4.9 out of 5 stars 30 reviews

Abnormal glabella movement after Botox

What you describe is not normal, but not a biggie.

You have an incomplete response to Botox most likely, so an additional "touch up" should take care of it.


Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.8 out of 5 stars 106 reviews

13 Units of Botox to Glabella

I always inject more than 13 units of Botox  when treating unwanted muscle contraction in the glabella. Perhaps you have residual contraction which can be controlled with additional medication into active muscles. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Getting the right Botox treatment

I believe you were not treated with enough Botox as I rarely inject less than 20 units into the glabellar area. With proper dosing these treatments are predictably reliable. I would never start someone with 10 units of Botox as their initial treatment. Anyone can inject neurotoxin injections such as Botox, Dysport or Xeomin but doing it safely and correctly requires each patient to be thoroughly informed and assessed. A specific treatment plan is developed based on patient desires and a comprehensive aesthetic evaluation. It is as much an art as it is a science.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

My Glabella Area Puckers Sometimes on It's Own After 13 Units of Botox, Normal?

  I have injected one or more of the neurotoxins (Botox, Dysport and the newer Xeomin) since 1990 and the crinkled skin effect is something new to me that I haven't heard before.  Botox and other neurotoxins injected into the Glabellar area can cause the other muscles, in the area, to compensate making curtain like ridges.  The answer is more Botox to relax the over-reacting muscles.  You could always just let the 13 units of Botox wear off which should be in about 3 months from the time it was injected.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Botox to glabella region

Botox in the glabella region should last 3-4 months. If only 6 weeks, then perhaps it was not injected accurately or enough.

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

Imbalanced BOTOX treatment.

The ultimate solution is a different injector.  One needs balanced treatments.  It is the job of the injector to create this balance so that you don't get funny muscle recruitment issues irrespective of the dose of BOTOX.

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

Low dose Botox to glabella causing problems

The usual dose of Botox to the glabella is considerably higher. Also each patient has different muscles that cause objectionable frowning. So the treatment is different for each patient. Likewise, every action has a reaction, and Botox administration should be balanced and thoughtful. Botox administration can make patients look rested and younger, or, if clumsily done, just 'strange'. Botox should not be administered in a rote fashion, but tailored to each patient.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 178 reviews

Glabellar Muscles Are Strong

The glabellar muscles are fairly strong muscles for their size and may simply be a case of needing a higher dose of Botox to be injected.  When injecting these muscles with Botox, I will always use a good bit more than 13 units.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 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.