Should I return to clinic after Botox? I still have crows feet and frown lines 5 days post op (Photo)

I had Botox 5 days ago in the horizontal forehead lines and crows feet, whilst I see a difference in my forehead lines when I frown I still have lines above my right eye brow. This is the only place on my forehead to crease, I have only today seen a tiny amount of difference in my crows feet however the lines are still very much there , is the Botox likely to change any more in this area or should I call the clinic? Thanks

Doctor Answers 14

It may not change any further, but to be sure wait 7-10 days to be sure

Hi Dani_79,

The residual lines above the outer portion of your eyebrow will unlikely change any more.  Most injectors will not inject within the 1 inch above the eyebrow to prevent the eyebrows from falling too low.  Since you appear younger, the injector may be able to place a couple of units near the top portion of the 3 wrinkles to help smooth those wrinkles out.  However, you need to be aware that your eyebrows may feel heavy since you will not be able to raise your eyebrows.  For some younger patients, they fully botoxed forehead, does not feel heavy, but for most older patient it will feel heavy and the eyebrows can appear low.

As for your lower eyelid wrinkles, these will unlikely improve, mainly because those wrinkles are not true "crow's feet."  The crow's feet are located to the outside corner of the eye, and they form wrinkles when you squint your eyes.  It appears that you are smiling in the second photo.  If you are smiling, the crepey skin on your lower eyelids are bunching together, because your smiling muscles are pushing your cheek fat upwards and causing the crepey skin to push together.  It may be possible to add a couple of units towards the outer corner, but the injector has to be careful not to inject under your eyes, since this can relax the lower eyelid muscle too much and cause eyebags too form.  On Realself, there are multiple reviews from Realself users who report botox injection directly under the eyelids to help smooth wrinkles, only to backfire and create eyebags.  Although in theory, as the botox wears off the eyebags may still be present.  So be careful with botox directly under the lower eyelash area.

In our practice, we try to nourish the crepey skin to make it more elastic, by using Obagi Elastiderm eye cream, which encourages new elastin fibers for form.  Most likely a good moisturizing eye cream can also improve the "plumpness" and elasticity of the skin, to help the lower eyelid skin snap back instead of wrinkling.

The goal is to make the lower eyelid skin more "spandex-like" and less "linen-like."  If the skin under the eyes is like linen, then any amount of movement will cause wrinkles.  If it is more like spandex, then it will contract when you smile or squint, instead of wrinkling.

I hope that makes some sense.  Hopefully a few more days will give you the results that you want, but it sounds like the botox already started working in other areas, so your concerns may be valid.


Dr. Yang

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New York Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Too early to tell

Botox can take up to 21 days to have it's maximal effect.  So, it's best to wait a little bit longer to see if this happens, before deciding if you need a touch-up dose.  Hang in there!

But if you don't see an effect by this time, by all means, contact your injecting physician.

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 79 reviews

When to return to clinic after Botox

I find Botox generally starts working after 2-4 days, although maximum effect is at 2 weeks, so I generally do not advise any reassessment or retreatment for at least 2 weeks. You are likely to get continued improvement, so be patient. If after 2 weeks the results are not optimal, go into the clinic and discuss with the dermatologist your options.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.8 out of 5 stars 50 reviews

Botox, 5 days post

Botox usually takes effect in 1-2 days, but can take up to a week for full results.  If you haven't seen a full result in 2 weeks, you need to call your doctor for a touch-up.

Charles A. Wallace, MD
Dallas Plastic Surgeon
4.2 out of 5 stars 6 reviews

Appropriate timing for Botox retouch

Botox will begin to take effect in 1-2 days, and will usually be fully active by a week.  However, in some patients, it may take up to 2 weeks.  The best time to go for a "retouch" is around 2 weeks, after the Botox has had appropriate time to take full effect.  Your clinic should be able to address those problem areas at that time.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews

Botox after five days, be patient

Be patient, you should not judge your results until you reach the two week mark. We often see results from Botox in five days but this can just be the beginning of what you will see. If you are not happy in two weeks see your doctor again.

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 18 reviews

Still With Wrinkles Post Botox

You have to wait 10-14 days before deciding on more treatment.  After which you should return to your physician and sometimes a touch up is needed.  Botox may not get rid of all the lines, most often we do it in a manner to soften the lines so that the effect isn't as unnatural or noticeable.  I wish you the best of luck, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 191 reviews

5 days after Botox treatment

Botox generally takes about one week to take effect. I would recommend giving it a bit more time, and follow up with your provider if you have any concerns about the end result. I hope this helps, and I wish you the best of luck. 

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews


First, botox full effects take about a week. Second eliminating the ability to raise the lateral brow can cause brow ptosis.  So some lines shoudl remain.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Forehead Lines After Botox

Botox can work on each muscle differently. This depends on the dose given and the uptake into the muscle. This can differ so that some muscles will be deactivated at varying times. Thus, the muscles above your right lateral brow may be taking a bit longer. I would give this another week to smooth out. If at that time you still have the ripple, return to your physician and have a mild touch-up. 1-2 units of Botox or Xeomin will correct the problem very easily. Your physician will be pleased because you are a walking advertisement for or against his/her work, and you will be pleased since you will have achieved the look you want. 

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 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.