Botox injection in glabella didn't work (10 units), returned 3 weeks later and it was suggested I add Dysport (10 units)

Question

because I have had success with Dysport before. I trusted the judgement but am now nervous that I added 10 units of Dysport in an area where I had 10 units of Botox 3 weeks prior. I had full movement in my Gabella and a ridge formed above my eyes. upper forehead took just fine as did my crow's feet with the botox. Thank you

Aldo Guerra, MD · Answer

Hi. I think what happened here is that your Botox dose was too low. I usually use at least 20 units in the frown line area to allow a natural looking wrinkle reduction. Perhaps you should return to your injector and discuss your concerns. Best, Dr. ALDO

William Franckle, MD, FACS · Answer

As the other doctors here have explained, generally speaking a Botox treatment in the glabellar requires 20-25 units. That does not mean you needed that because every patients are unique, this is simply a generalization. One other thing to keep in mind, it is common that patients will have a Botox or Dysport treatment than return within a few weeks and need more of one or the other. Be sure you are seeing a board certified plastic surgeon or dermatologist with experience in these types of treatments. Good luck!

Michael A. Zadeh, MD, FACS · Answer

10 units of Botox to the glabella is nothing. No wonder you didn't see results. 10 units of Dysport is the equivalent of a little over 3 units of Botox. So you'd basically be adding nothing to nothing. The glabella usually requires between 20-25 units of Botox for adequate results. Some people may even need more depending on the depth of lines and muscle activity. Please find an experienced injector.

Kenneth D. Steinsapir, MD · Answer

How about seeing an injector who knows what they are doing.  Don't go to a medspa for botox or fillers unless there is a very experienced physician on premises doing the service.  There is just no substitute for experience.

Corey Frucht, MD, PhD · Answer

Hello, and thanks for your question. You had 10 units of Botox and 10 units of Dysport, which is equal to about 4 Botox units. You therefore had about 14 units total, which is a low dose. I usually inject 16-24 units for the glabella, and my patients tend to improve natural, subtle results over the "frozen" look. I think you just need more product to achieve the look you are seeking. Best of luck, Dr. Frucht.

Adam Goodwin, MBBS, FRCS(Plast) · Answer

so dysport dosing is about 2.5 to 3 times lower per unit than botox. Having said that, there are some unique advantages in my experience.  It has a greater area of diffusion so gives a more even effect for fewer injections and I believe that a conversion of 3:1 units (botox equivalent) it can have a longer effect. Try to wait a few days but dont be put off by dysport altogether. Adam Goodwin

Steven F. Weiner, MD · Answer

10 units is extremely low dosing. Adding 10 units of Dsyport doesn't even make sense because this is actually about 4 units of Botox. Glabella's need about 20-30 units of Botox for effective treatment and can go as high as 60 or more in strong men. You were underdosed.

Botox injection in glabella didn't work (10 units), returned 3 weeks later and it was suggested I add Dysport (10 units)

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