I had Botox one week ago and now appear to have a v shaped on my forehead. Will this soften or is more Botox required? (photo)

Doctor Answers 12


I normally would wait two full weeks before returning to see your physician after having Botox. You may need additional units to give you the look you require, but this is an easy fix.

Fort Lauderdale Oculoplastic Surgeon
4.9 out of 5 stars 77 reviews

V-shape on forehead after botox

The v-shape is due to prominence of muscles that will likely need additional units of botox.  It may improve slightly over the next few days as full effect of botox is about 2 weeks.   But I would set up a return visit for a touch-up.

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 7 reviews

Botox and V shape on forehead

Botox is an injection that weakens muscles to produce fewer wrinkles on the skin.
After a treatment becomes effect, dominant muscle patterns may reveal themselves as the treated muscles weaken. You may need to have those other muscle groups injected to even out the result.
Before a first time Botox injection, I perform a consultation including a medical/injectable history, physical exam of the facial muscles, and photoanalysis of the face in different expressions. This helps me identify issues with symmetry and dominant muscle groups. Then I customize each person's injection for a safe and happy outcome. Safety comes first. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Botox can take 2 weeks to settle in.

If the results are perfect at 2 weeks following a Botox treatment you may need a touch up.  This is an easy and inexpensive thing and ensures that you will love your Botox!

Susan Van Dyke, MD
Paradise Valley Dermatologic Surgeon
4.7 out of 5 stars 29 reviews

Botox and Results

I suggest waiting a few more days, it takes up to 2 weeks to see the improvement. and if there is no improvement, return to your injector. This can be improved with additional Botox treatment. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

For head V shape one week after Botox injection.

What you are seeing is unusual in my experience after Botox but I would suggest strongly that you wait another week before returning to your doctor.  The effect of the Botox may be seen earlier in some portions of your forehead than others so being patient is appropriate.  If it persists however your doctor will probably need to supplement the Botox to balance your forehead better.  Good luck.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

Botox on the forehead

Thank you for your question Megs188. Botox is a great treatment to address wrinkles on the forehead. Any time I perform a Botox treatment on the forehead, I recommend treating both the frown lines in the glabella and the horizontal lines across the upper forehead. This is because one muscle pulls the brow down and the other pulls it up. If one muscle is relaxed, the opposing muscle will work on its own and new wrinkles may appear. That being said, it could take up to two weeks to see full results of a Botox treatment. Please follow up with your doctor at that time for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 1 review

Problems with Botox

You may have a little improvement over the next week, but I doubt it will resolve on it's own. I recommend you see your injector and let them examine you. Additional Botox should be able to make this go away, and adapting any future injections can prevent this from happening again.
Andrew Campbell, M.D. Facial Plastic Specialist Quintessa Aesthetic Centers

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Seek a Board Certified MD Surgeon for Treatment

Botox treatments are an art form.  I would advise seeking out only a board certified MD expert in Oculoplastic Surgery, Plastic Surgery, Facial Plastic Surgery, or Dermatologic Surgery for cosmetic treatments of your face.  Once you select a surgeon to treat you, a rapport with them will allow him/her to work together with you to achieve excellent, customized results. A touch-up may improve your concerns. Best of luck!

Damon B. Chandler, MD
Moorestown Oculoplastic Surgeon
5.0 out of 5 stars 2 reviews

V-shaped forehead after Botox

Sometimes when treating the forehead with Botox, the forehead muscles (frontalis) aren't adequately treated out to the sides, resulting in the outer part of the brows and forehead raising up, and the inner portions staying relaxed. Some call this the "Spock" look. An experience injector with have you raise and lower the eyebrows and forehead before injecting to locate and target all the muscles that need to be treated.  

Matheson A. Harris, MD
Salt Lake City Oculoplastic Surgeon
5.0 out of 5 stars 6 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.