Why Do I Get Such a Strong Response to a Low Dose of Botox in the Glabellar Region?

1st time - 20 units Awful. The next day I was completely paralysed in the glabellar and it got worse, along with a botox headache, for a week which was unbearable. I looked so unnatural not being able to move my eyebrows at all. 2nd time - 10 units Still too much and I had a botox headache for about a week. 3rd time - 6 units Still too much, can't move eyebrows at all, but thankfully no botox headache. So looks like 2 or 4 units maximum for glabellar. Why?

Doctor Answers 6

Botox dosage

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Everyone's Botox treatments should be individualized.  You are fortunate that a small amount of Botox is effective for you.

Toronto Dermatologist

Botox is individualized

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Just like some people will need twice the normal amount, some people will need much less. The standard injection to the glabella is somewhere between 20-25 units. But if you get a good result with very few units, awesome. I've never seen this small of an amount be effective, but if it works for you, great news.

Botox treatment must be individualized

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Everyone is built differently.  Some muscle mass may require 35 units in the glabellar (between the eyebrows) whereas other people may only need less than 10 units int he same site. The physician normally tries to get a sense as to how many units of Botox would be required to relax that muscle group.

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

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Why Do I Get Such a Strong Response to a Low Dose of Botox in the Glabellar Region?

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Patients responses to neurotoxins like Botox, Dysport and Xeomin are varied and do differ based on the thickness and overall size of the targeted muscle.  If you find the optimum dose and it's low, all the better IMHO.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
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Everyone is a bit different.

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20 units can be a large dose for some people.  The bigger the muscle mass, the more BOTOX is generally required to get a similar effect.  I do have patients who simply to not tolerate glabellar treatment.  They feel "locked in" when treated in this particular area.  A few of my actor clients avoid this area because they are accustom to a certain range of facial expressions.  Generally people like the effect of BOTOX in this area but it simply is not one size fits all.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
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Strong Response to Low Dose Botox

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Different people react to neurotoxins in different ways.  If you are lucky enough to get your desired result with 2-4 units, this is wonderful news.  Great results with fewer units and no headache sounds like a winning combination!    Also, it will save you money.

Sheri G. Feldman, MD
Beverly Hills Dermatologist

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.