Complete Movement 4 Days After Botox - is This Normal?

I had Botox for the first time on Friday between my brows. The doctor used 20 units. At first I had limited movement in this area but now I have much more movement than I expected. Also the lines are getting more like they were before the Botox was done. Is this normal and when can I ask the doctor to do a touch up?

Doctor Answers 6

Botulinum Toxin (Dysport and Botox) and time for effect

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Notify your doctor's office by 7-10 days but do not schedule an appointment for at least 2 weeks. It sometimes takes at least w1-2 months for the wrinkles to relax after the muscles are denervated.

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Complete movement 4 days after Botox

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There have been occasional reports of "bad batch" of Botox in which the Botox injected did not have the desired effect.  I would wait about 1-2 weeks and see if there is still not effect and then bring up your concerns with your treating physician.

A reasonable thing to do at that point may be to inject more.  I've had some patients with extraordinarily strong muscles who required double or triple the amount of Botox of a normal person.  You can't tell who those people will be until after you've worked with them.  After injecting more, you may achieve the desired effect or you may see some improvement but still require more at which point you may even need to go back a 3rd time.  If after injecting more Botox and there's still no improvement, then it's possible there may be something wrong with that particular batch of Botox and the physician may have to report that to Allergan.  In the past when there was a "bad batch" of Botox and it was obvious that none of the Botox from that batch was having any effect on the patients, Allergan would reimburse the physician for the Botox so they could reinject the patient at no charge.  But you'd have to consent to being reinjected to see if that were the problem.  (In other words, don't  just assume the Botox didn't work until you have the physician inject more.  It could be just your individual variation from the norm.)

M. Christine Lee, MD
Walnut Creek Dermatologic Surgeon

Onset of Botox

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It can take one to two weeks or even more for the full effect of Botox to register. Be patient and followup with your doctor. It is not unusual for physicians to be conservative and treat with more units on a subsequent visit should your musculature require more units.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

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Delayed onset of botox effects

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The  effect become fully established  in one to two weeeks. It also depends  upon the concentration and age of the Botox  used and the size of the muscles treated. So if you do not see any results in two weeks please see your physician for a possible touch up

Zain Kadri, MD
Los Angeles Facial Plastic Surgeon

Botox with movement at 4d

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It takes more than a week to see the full results of Botox. It sounds as if you may not have had enough either units or injection sites. When the Botox is injected into the muscles of the glabella, there are surrounding muscles that can be flexed in the forehead to still see the glabella lines, and you forehead can work harder to do this compensating for the inactive muscles injected. Sometimes more injections are needed to see the desired result. Consulting with your injecting physician and explaining your expectations would be beneficial.

You should see the complete effect of Botox 7-14 days after your treatment.

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You should wait one more week to assess your Botox result. If you're not pleased with the appearance of your brow in a week, you should bring these concerns to your doctor. A dose adjustment with another 10 units or so might be necessary. I hope this is helpful.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 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.