I cannot see any effects of the Botox which I had 7 days ago.

I can still frown and raise my eyebrows with all the wrinkles still showing. I had 40 units 7 days ago. How many more units should I get for my glabella lines and wrinkles around the eyes to soften? How more days to wait?

Doctor Answers 13

The pivotal studies demonstrated that the peak effects of Botox are seen 14 days after the treatment

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Thank you for your question Silvertone. Botox is a purified protein used to address wrinkles associated with facial expression such as the vertical lines seen between the brows when one frowns. Most people see the results of their Botox treatment 3-7 days after the treatment. But it could take up to two weeks for full results. The pivotal studies demonstrated that the peak effects of Botox are seen 14 days after the treatment. Patience is important. In our office patients return two weeks after a treatment for after photographs in order to assess their results. Please consult with a doctor for specific recommendations. Good luck!

Botox Results

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Dear Silvertone,

Thank you for your clinical post. In general, Botox and its sister neuromodulators Xeomin and Dysport will make its way down to the target muscle within 3-4 hours of injection. Onset of clinical effect often occurs within 3 days in many patients, however, most physicians advise patients to allow up to 7-14 days for full effect to exert itself. Depending on the size of the facial anatomy and the size of the facial muscles, the activity of the facial muscles more or less Botox may be required for function such as softening a frown line, lessening Crow’s Feet, softening forehead lines and elevating a brow. In general, 40 units is a small amount if you have strong frown line muscles, strong Crow’s Feet and a strong forehead muscle, often 60-75 units may be required for a true brow lift effect and to soften or eliminate frowning.

Once you have allowed 2 weeks for full effect I’d revisit your injection professional and discuss the next steps. More Botox in the same areas is likely indicated. Of course, ensure that the Botox was not left out of the fridge for a prolonged period of time, had been mixed fairly recently and the physician or nurse had not experienced any decreased efficacy with that lot number.

I’ve been injecting Botox and soft tissue fillers as well as doing facial cosmetic plastic surgery for over 20 years and have found very few people to have true antibodies to Botox so I think this is simply a dose symmetry issue.

I’m sure you’ll get an excellent result and best of luck.

To find out more, please visit the link below.

R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Yorkville, Toronto

R. Stephen Mulholland, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 101 reviews

Wait a Few More Days

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Hi Silvertone. Your concerns about BOTOX results not appearing after a week are fairly common. Even though many patients begin seeing some results within 7 days of the procedure, a final outcome sometimes takes 10 days to 2 weeks to emerge. My advice is to be patient and see what happens after another week. If you still haven't noticed any difference, then call your provider and discuss your options with him or her. Your provider may recommend more BOTOX or an alternative. Good luck.

Otto Weiglein, FRCSC
Burlington Plastic Surgeon
5.0 out of 5 stars 6 reviews

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Botox Results

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Thanks for your question. Botox can take up to 14 days to see full results. You will start seeing some difference in the next few days.

Henry Mentz, MD, FACS
Houston Plastic Surgeon
4.4 out of 5 stars 36 reviews

GIve it another week

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Typically it takes 5-7 days to notice the effects of Botox.  However, it may take as long as two weeks.  I recommend waiting another week.  If you still have muscle movement of the treated areas, you should consult with your doctor.  Good luck!


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Thank you for your question in regards to Botox.
Botox can take up to 14 days to take total correction. After two weeks, contact your provider for a follow up appointment to discuss at that time if you need additional units of Botox.To be sure, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment.
I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

No Effects from Botox after One Week

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  • Usually, one week after Botox most patients are noticing a change in their wrinkles.
  • But I have seen it take as long as two weeks to notice the full effects. 
  • Therefore, wait a full two weeks, and if you have questions about the results at that time, additional Botox injections could be considered. 
  • Thanks for sharing!

7 Days After Botox

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Thank you for your question.

Botox usually takes 2 or 3 days to start to work, and will continue to improve over the first 7 to 10 days. The full affect is typically achieved after 14 days.

Should you not notice any improvements after 14 days, I'd recommend booking a follow-up appointment with your skilled and qualified injector. 

Take care.

Botox Results

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Thank you for your question and I'm sorry you are experiencing less than satisfactory results from your recent Botox treatment. It can take some patients longer than 7 days to see the effects of Botox. But if you are concerned, I recommend following up at your earliest convenience with the surgeon who did the injections. Upon an in person evaluation, they should be able to tell you what's going on. Please remember to always use a Board Certified Plastic Surgeon who has extensive experience with Botox injections. Your satisfaction should be top priority! Best wishes to you for good results! 

Michael K. Obeng, MD, FACS
Beverly Hills Plastic Surgeon

Botox effect

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Thank you for your question.  Most patients will see some sort of result at 1 week out, but the full effect of Botox can take up to 2 weeks to see.  If after another week there is no response I would return to your physician and discuss with them your concerns so that they may further manage you either by adding additional Botox or using another product like Dysport or Xeomin.  You also may question them exactly what dilution was used and how long prior was the product diluted before it was injected.  Regards, Dr. Matt Elias

Matthew Elias, DO, FAAD
Fort Lauderdale Dermatologic 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.