Need More Botox In Forehead After 6 Weeks, Shouldn't It Last Longer?

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 problem2) 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.

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. 

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.

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.

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.

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.

There are several factors that determine how long Botox (or Dysport) will last, including the dose, the size of the muscle, and the intensity of effect that is desired. For most facial regions including the forehead, 3-4 months would be typical and 6 months unusual. The first time, the dose is an educated guess so the fact that your effect wore off sooner than desired will be used to help determine the dose the next time. It is also important to consider what sort of effect is desired - total paralysis can cause the eyebrows to drop and the frozen look isn't always desirable.

Botox typically last for 3-4 months in most patients for forehead and eye wrinkle treatment. Results appear after several days. The facial muscles are temporarily immobile for several weeks then gradually regain movement. The wrinkles after Botox Cosmetic do not suddenly return, but rather you will see some facial movement before the 3-4 month time frame. 

Every patient responds differently and may have shorter or longer duration of results. Lastly, some patients may require more Botox for adequate results. Only after a comprehensive evaluation can a specialist help determine appropriate options for you. Best of luck.

Dr. Chaboki

 

In my experience, your forehead will remain nearly motion free for 6 weeks following your injection. You will then experience a gradual return of forehead motion from 6 weeks to around 16 weeks, depending on you. You are probably only noticing slight mobility of your brow while maintaining a nice cosmetic result.

I hope this is helpful for you.

Regards from NJ.