Botox, is it supposed to look like this? (photo)
Doctor Answers 26
More time for Botox to work
Thank you so much for your question and photo. We do not have a "before" photo to compare thus unable to see what progress has been made. Secondly 3 days is not sufficient to make any determination as to effectiveness, correct dosage and areas potentially in need of a touch up. Make plans to go back to the office where you had your Botox at the 2 week mark and any touch ups if needed or other concerns can be addressed. Being your first time many will treat very conservatively to assess your response and fine tune after that. I am of the camp that believes for best results overall counter balancing the forehead with the glabella region or vice versa is a good idea. Tincture of time is needed at this point. Be well.
Peak effects of Botox are at about 2 weeks after the injection session - you do need to balance glabella and forehead
Thank you for your question. You submitted one photo and describe you had Botox™ for the first time, and your physician recommended, in addition to doing the forehead which you want done alone, you do the glabella as well. You decided to have just the forehead done, and submitted a photo three days after the procedure and ask if it looks normal.
I can give you some guidance on how to continue with Botox™, and understanding the process. It’s likely your doctor discussed this with you, but since this is new for you, it is important to understand some basic ideas.
A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years. My specialty of oculofacial plastic surgery was among the first physicians using Botox™, so I’ve been using Botox™ for patients since 1993.
To begin, it’s very important to understand the concept of how Botox™ works. People often believe Botox™ is a filler, which it is not. What Botox™ basically does is improve the appearance of wrinkles. There are 2 types of wrinkles: dynamic wrinkles and static wrinkles. Dynamic wrinkles are wrinkles that occur when you activate muscles. Static wrinkles are wrinkles that occur regardless of muscle activity, so are present at rest.
Botox™ relaxes muscles. The forehead with the glabella are actually 2 different sets of muscles. The forehead muscles you want to smoothen is the muscle that lifts the eyebrows called the frontalis muscle. In the photo you submitted, it appears you have some movement of the frontalis muscle in the lower part, while the upper part looks relatively smooth. It is likely the area your doctor injected, and limited the area closer to the eyebrow, or the glabella. The glabella is the area where the frown lines are, and is often done in combination to help rejuvenate the forehead. As an aesthetic unit, you want to improve the horizontal lines in the frontalis muscle, and as the vertical lines AKA number 11 lines of the glabella.
Your doctor was likely concerned it may look unnatural or not in harmony. It is also important to understand the timeline for the effects of Botox™. You can start seeing changes as early as 24 to 48 hours, but in my practice I have people come back in 2 weeks. Clinical studies shown the peak of effect Botox™can be around 2 weeks, so that is when I determine the effectiveness, and whether enhancement is needed.
Another important element is what is causing the horizontal lines to form. People often raise their eyebrows very aggressively because they have drooping brows, or have extra skin over their eyes called dermatochalasis. Unconsciously, people will reflexively raise their eyebrows, which form horizontal lines, so it is a challenge for the practitioner. Since I don’t see the rest of your face, this is just some additional information.
You do not want to do Botox™ so aggressively that the forehead completely relaxes so the brows drop, or have a completely smooth forehead that won’t fit the rest of the face. Allow yourself some time to evaluate the result. Visit or contact your doctor in about 2 weeks from the time of your injection for reevaluation. Learn more about this, and I stress strongly to find a doctor you are comfortable with, and you feel can work with you as you continue your journey into doing this in a more consistent basis. I hope that was helpful, I wish you the best of luck and thank you for your question.
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The Botox usually takes 5 to 7 days to see the full effect. It would have been a good idea to get it all at once as suggested by the injector, that being said nothing wrong with calling and getting another appointment for the Glabella and it will also soften the lines on the side.
It looks like you have strong forehead and glabella muscles. It is difficult to treat those lower brow lines without causing the brow to drop especially when not balancing the treatment with botox in the glabella ( the muscles responsible for the vertical lines when you furrow your brow). It is not uncommon to start with a lighter treatment for a first time treatment and add additional botox if needed, so don't be discouraged My personal preference is to treat these areas together and rarely treat the forehead in isolation. However at 3 days post injection, botox has not reached its maximal effect so you may want to wait a week, but there is a good chance you will need to return to your injector to discuss additional treatment.