Was Botox injected too low in my glabella? (Photo)

I’m not sure what you were trying to achieve, 30 units of Botox in the glabellar area is a bit too much. 16 -20 units are more common. That much Botox may cause your brow to drop.

Thank you for sharing your excellent question and photographs.  Based on your picture, the position of injection for your corrugators to eliminate the vertical wrinkles appears correct while the injection for the central procerus muscle is okay, but could have been placed lower.  That said, 30 units is a bit high for most patients and your dosing would depend on an in-person examination.  Hope this helps.

Thank you for sharing your question and posting your photograph. The injection was definitely not too low. In order to elevate the brows, the Botox needs to be place low (near the brows). I hope this helps.Good luck,

The placement of injection in the photo looks fine to me. You want to put injections low in the glabella to about notice getting into the frontalis muscle above the glabella.  Weakening of the lower frontalis above the brow is what causes heavy droopy brows. If anything, your injector probably could have actually injected lower.

Thanks for your question and photos. I have never placed 30 units of Botox to the glabella. The typical amount would be about 15 units to the glabella. The injection technique that you show in your photos is not typically how it is done. I inject Botox with the glabella/forehead relaxed and use a 33 gauge needle which causes a lot less injection pain. Botox will not elevate the eyebrows as the forehead muscles keep the eyebrows up so putting Botox in the forehead may cause the brows to drop if anything. 

In the picture, it shows the correct area for placement, but depending on how the muscles react, 30 units may be too much.  The only way to know is to wait for the complete effect and then determine if it was placed correctly and if the amount is correct.

Thank you for your question and photos. Based on the pictures provided, the position of injection for your corrugators to eliminate the vertical wrinkles (11 lines) appear to be in the correct location/position. 30 units in the glabella is a normal or typical amount used for men. Always follow up with your injector to discuss any questions or concerns. 

Thank you for your question and for sharing your photographs uniformbee. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.The appearance of frown lines is variable from person to person. Usually they are in a vertical orientation but sometimes they can be oblique and sometimes a horizontal line is seen across the upper portion of the nasal bridge. The most common variation is to have two parallel lines, hence the common term "11's" to describe them. But some people have one, three, or more lines. Some people also will see a bulge in the area when contracting the muscle. This bulge is smoothened out after a Botox treatment.The pivotal studies used 20 units of Botox in the glabella area between the brow to address the frown lines. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary.Although 20 units is a good standard dose to start with, some people require a higher dose because of higher muscle volume. This is common in mature patients, in those with large bulges from expressive faces, and in men. I find that Botox still works in these cases, just a higher dose is required. I have used up to 40 units in the glabella.When patients present with concerns about specific wrinkles in the upper face such as the frown lines, I always assess and usually treat the other wrinkles in the upper face including the horizontal forehead wrinkles and crow’s feet. The reason is to maintain a harmonious and natural balance to the appearance of the upper face. The muscles in the glabella which are responsible for the formation of the frown lines serve to pull down on the inner brows when a person frowns. Similarly, the muscles around the eyes which are responsible for the formation of the crow’s feet seen when smiling (orbicularis oculi) are also responsible for pulling down on the brows, but in this case the outer brows. On the other hand, the muscle in the upper forehead which is responsible for the formation of the horizontal forehead wrinkles when a person raises the brows (frontalis) serves to pull the brows upward. If one of these muscles is relaxed with Botox and the others are not, the other muscles will still be active. This will lead to an unbalanced and unnatural appearance of the upper face where the brow can be elevated, depressed, or uneven in shape or position. Therefore, I recommend that my patients take a global approach to the upper face when receiving Botox treatments and treat all three of these areas. Sometimes bunny lines on the bridge of the nose are also treated.According to the manufacturer's guidelines, Botox is placed in five points between the brows in a V-shape patter. This addresses the glabellar complex, which includes multiple muscles. A demonstration is shown in the video here. In the photograph provided here, only one point is being shown and more photographs are not included. However, the injection point shown here is one of the points where Botox is typically placed when treating this area. If I had a patient with this concern I would recommend that she wait a full two weeks before assessing her results.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!

In the picture, it shows the correct area for placement, but depending on how the muscles react, 30 units may be too much.  The only way to know is to wait for the complete effect and then determine if it was placed correctly and if the amount is correct.  Good luck!

The picture appears to show an injection to the right supracili muscle and looks correctly positioned, but this can not be totally reliably judged from a photograph. This is not the glabella which is in the middle between the eyebrows. The supracili muscles cause the vertical lines in the glabella so Botox in the supracili muscle is to smooth out the glabella area between the eyebrows. Injections at this site are not usually planned to affect the brow.30 units depends on the brand of botulinum toxin. The units vary with the brand. For the Botox brand 30 units is higher than I would normally have used first time to treat the glabella area but that does not mean it was wrong in the hands of a trained and experience practitioner.Best wishes.