I am noticing some movement back in my forehead after my first round of Botox 6 weeks ago. I was expecting a time range of more like 6 months! Should I make another appointment for more now or wait until I have full movement? Is this 6 week time frame shorter than normal? Not sure the money is worth it if I have to have 20 units every 6 weeks...
Need More Botox In Forehead After 6 Weeks, Shouldn't It Last Longer?
Doctor Answers 22
Thank you for your question and concern. I train a lot of injectors in the proper technique for Botox injections. Here are some of the common reasons that Botox wears off too quickly:
1) Inadequate dose - higher doses usually corrects the problem
2) Cookie cutter approach to injecting Botox. The same technique is used for every patient and it works for most, but not all patients. The cookie cutter approach fails to appreciate the differences in anatomy of the facial muscles that can vary by the individual.
3) Rarely, there are patients who truly have shorter durations with Botox and may want to consider the different neuromodulators available to see if there is a difference.
It sounds like you might want to consider trying slightly higher doses, but becareful not to be too aggressive as you may develop a heaviness in the brows.
I would recommend that you go an experienced board certified plastic surgeon or dermatologist who does a high volume of injectables to discuss your experience in more detail.
1) Inadequate dose - higher doses usually corrects the problem
2) Cookie cutter approach to injecting Botox. The same technique is used for every patient and it works for most, but not all patients. The cookie cutter approach fails to appreciate the differences in anatomy of the facial muscles that can vary by the individual.
3) Rarely, there are patients who truly have shorter durations with Botox and may want to consider the different neuromodulators available to see if there is a difference.
It sounds like you might want to consider trying slightly higher doses, but becareful not to be too aggressive as you may develop a heaviness in the brows.
I would recommend that you go an experienced board certified plastic surgeon or dermatologist who does a high volume of injectables to discuss your experience in more detail.
Botox usually lasts about 3-4 months. Even though the administration of the Botox should be the same from office to office, there is definitely some variation in how physicians reconstitute it and how long they keep it on the shelf. If you are experiencing movement after 6 weeks then you should speak with your physician about your concerns. Sometimes a touch-up can be performed. If it continues to be a problem, then try a different office. Only rarely does a person metabolize the Botox that quickly, but if the same thing happens at another office, that could be the case.
Like many other areas of the face that are treated with Botox, results last about 3-4 months for the forehead, or possibly a little longer. However, in general, it's better to be a little less aggressive when treating the forehead to prevent the risk of drooping, particularly since you are a "first timer". You may have received fewer units so that your reaction to treatment could be gauged first.
Web reference: https://www.youtube.com/user/EdelsteinCosmeticTV
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Most experienced injectors do not treat foreheads aggressively with Botox, especially on your first visit. It is better to add more units later if necessary rather than use too much to give a frozen or droopy look. Please return to your injector for re-assessment.
There are many individuals that can not have all of the forehead treatment without concern of the forehead dropping and affecting the eyebrow and even eyelid position if this phenomenon of forehead sagging had already occurred. These individuals need some function of the forehead to be left intact after Botox to avoid this drop as the forehead helps lift those areas. Keeping this in mind, the physician tries not to inject those danger areas but then partial treatment may induce compensatory over contraction of other areas and the outer eyebrows may get lifted. With this nearby contraction, possibly your botox is wearing off more quickly. The company's insert does state 8 to 12 weeks for glabellar frown lines longevity of Botox effect. Six months is not seen clincally for the vast majority of patients. I typicaly see 12 to 16 weeks of duration. You might need more units than you had but they must be in the correct areas to avoid the droop and the glabella between the eyebrows probably has to be treated to help lift the forehead while treating the forehead for its horizontal creases at the same time as the forehead could drop.
Web reference: http://www.thenyac.com/botox/index.html
It maybe that you are requiring more product than what you were once receiving. Or that getting a little mini touch up between your usualy dose treatments may be a good option. The first time a patient receives Botox they will generally notice the biggest difference. As we get used to our " new look" sometimes we can become over critical of a little movement. Try to space your treatment out between 3-5 months. Getting a few more units after 10 days have passed is not uncommon.
Dosage, dilution, & hyper-dynamic muscles are the three key reasons for failure of Botox. You must ask the provider what dilution is being used & how many units you are receiving.
Much information has been provided by panel members.
Quite simply, you should be receiving a longer duration of effects with 20 units of Botox to your forehead. There may be a several factors involved that are contributing to this problem: improper dilution, dosing, placement or possibly a developing resistance. Ideally, you should be holding onto duration/benefits longer as you become more consistent with treatments.
It is not recommended to get frequent dosing in less than 3 months. Your concerns should be addressed by the one doing the treatments to determine a way to obtain a better duration.
Web reference: http://www.celibre.com/botoxInjectionsBeforeAfterPicturesPhotos.aspx
The FDA approved Botox for a duration of three months. Granted this is just an average as results will vary for each patient. Some people will see the effects last longer than 3 months and others will experience shorter than 3 months. It may be an issue that you did you receive enough units of Botox in the desired area, which in this case is your forehead. At Contour Dermatology we typically require 20 to 50 units for the forehead. I also have all of my patients come back for a two-week, follow-up appointment to make sure they are satisfied and to determine whether the Botox we gave them was an effective dose.
Thank you for your question.
For the majority of patients Botox generally lasts three to four months, however anywhere from two to six months is not uncommon. Botox wearing off at six weeks is a little earlier than expected and there may be several reasons for this. Receiving too little Botox or not having the Botox injected directly into the muscle belly may result in shorter lengths of effect. However, some patients will still experience shortened results despite appropriate doses and injection techniques.
In our San Francisco Bay Area practice we also recommend patients try Dysport, a different brand of botulinium toxin than Botox. Although Dysport is a comparable product to Botox and some patients prefer one to the other.
For best results visit the office of a Board-Certified Plastic Surgeon.
I hope this helps.
Web reference: http://www.trivalleyplasticsurgery.com/index.html
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.
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