I Just Received my First Botox Injections Yesterday and It's Worse, Not Better. Normal?

I just received my first Botox injections yesterday. They are from a very reputable plastic surgeon, so he knows what he's doing - but it seems that there is almost an EXTRA new wrinkle above my brow. It's as if the skin is weighing down on it and causing a new wrinkle. Not only that (and I know it can take up to a week to see full results), but I don't see even the most MINOR improvement whatsoever in my glabellar lines. I paid almost $600 for this, so I'm pretty upset. Any recommendations?

Doctor Answers 19

BOTOX® Cosmetic takes up to 7-10 days for full result.

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Don't worry, it is normal that there is no immediate result. Botox usually takes 7-10 days to have the full effect of the treatment. Though it seems unlikely that you would notice new lines over your brow so soon, there is a chance when treating the glabella that you may get "spock brow". This can happen when the area is over-treated or when the brow muscle is over-compensating. This problem is not common but easily repaired.

Botox can take a while to improve the glabellar lines

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Not only can it take up to two weeks for the botox to peak at its muscular relaxation effect, the deep lines between the eyebrows can take time to ease away. That's because those lines are there for many years of the muscle squeezing together. If you see your doctor and there is no muscular movement then the Botox is effective and the skin has to take more time to have the overlying wrinkles fade. That might take a couple to a few sessions of botox, not letting the botox wear off completely in between treatments so the skin doesn't start to contract again.

I have seen a few times, a new line that show on the outer forehead a half inch above the tail of the eyebrow. That's because we don't put Botox there for fear of dropping the eyebrow or eyelid and the outer eyebrow still can lift up pushing against the upper part of the forehead which has now dropped from treating it with Botox at the same time. Occasionally one unit of botox placed higher on the forehead than the new crease can help but we usually wait two weeks after the occurrence before we adjust. Sometimes that crease can't be treated with botox and careful placement of a thin filler can help. See your doctor for a thorough evaluation so they can benefit from seeing the line and adjust the next treatment when you're due for it again.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

First Botox injection results

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First of all, there is no way that the Botox can cause a new line to form and especially after one day. You may notice it because you are paying closer attention to your face now and have not noticed that line before. At Contour Dermatology, that is why we take photos before we do any procedure, cosmetic or medical, because patients tend to forget what they “really” look like.  Finally, it does take one week or so for the Botox to kick in, so be patient and wait the week or so.  If you still don’t see any results, then go back to visit the injector.

Timothy Jochen, MD
Palm Springs Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Glabellar lines after Botox

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Please give it some time.  The final result won't be obvious for up to a week.  As the Botox takes effect, you may have to be patient to assess what it is doing.  It's also possible that it is already working in one area and that this is changing your perspective on the areas in which it hasn't begun to work. 

1 day is too early to judge if the Botox works

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After spending a fair amount on your treatment I can see how you would be anxious to see instant results. However I tell my patients to wait at least a week before coming back in for any touch up injections. I have my patients do some facial expression exercises to ensure the treatment gets into the targetted muscle evenly and also have them refrain from cardiovascular exercise for 1 day after the treatment so the it is not carried away from the sites we previously targetted. 

Give it a few more days. One day is far too soon to evaluate results of Botox

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The average onset of Botox results is 3-5 days after injection and the full effects can take from 10 to sometimes 14 days.  1 day is far too soon to evaluate your treatment results.  You will most likely see more results from your treatment over the next week so try not to worry  and follow-up with your physician for any questions. 

Dan Mills, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 33 reviews

Two weeks for complete botox results

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If you JUST got the injections, don't expect anything yet. It takes 2 weeks for you to see the final results. Your wrinkles and lines should soften slowly over 2 weeks for a complete and natural look.

Gary Goldenberg, MD
New York Dermatologist


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If your glabellar lines are deeply engraved there may be only subtle improvement in their appearance with Botox alone.  As you know Botox weakens the muscle it does not fill in lines.  Your treatment may be improved by supplementing your treatment with a filler like Juvederm or Restyline to directly soften the glabellar frown lines.  I would wait a full 2 weeks, if you are still unhappy with the results set up another visit with your Plastic surgeon.

Botox and Dysport can help reduce forehead and glabellar wrinkles

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but with Botox it could take up to 14 days to see the final results.  If, after two weeks, you still feel that there are new or different wrinkles, see your doctor so that he can touch up the area if necessary.  Occasionally, if you have the glabella treated, the forehead muscles work a little harder and pull up the brow, causing noticible lines above the brow.  This can be treated by either adding a touch of botox to relax the lateral brow, or by using fillers such as Restylane.  Best to you.

Carolyn Jacob, MD
Chicago Dermatologic Surgeon

Botox Results

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The results from a Botox Cosmetic treatment takes a minimum of 3-4 days to start and as long as 2 weeks for full effect. Usually, results are seen about 1 week after treatment. Dysport may work faster.

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.