Corrugator muscles sore & seem more prominent/tensed after recent Botox. Is retreatment necessary? How long until it improves?

Can make out outline of corrugator muscles after receiving 14 units of Botox 4 days ago to treat single crease btwn brows. They were not noticeable to me before & the area feels tight/sore as if muscles are really tense and can't relax (opposite of what I thought Botox was supposed to do). RN says muscles possibly sore just due to being poked w/needle. Zero improvement noticed yet and area is sore. Should I wait longer? Retreat? Visit different Dr./RN? Unhappy so far and don't know what to do.

Doctor Answers 10

The peak effect of Botox is seen at 14 days after the treatment

Thank you for your question susanne77. I am sorry to hear about your situation. 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. The pivotal studies demonstrated that with a dose of 20 units in this area, the peak effect is seen at 14 days after the treatment and most people enjoy their results for 3-4 months. Patience is important. Please follow up with your doctor for specific recommendations. Good luck!

Encino Physician
5.0 out of 5 stars 4 reviews


Thank you for your question in regards to Botox.
Botox can take up to two weeks before total correction has occurred. I suggest waiting until then, at that time if you still have concerns with your injections, schedule a follow up appointment and additional units may be added. 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 183 reviews

Botox for frown muscles

Botox may take up to a week to kick in. Wait another week and see if there inward motion of the area immediately above the eyebrows when you frown. The movement stops first then the improvement happens later.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 38 reviews

Botox and Results -- Wait 2 weeks and see

Botox takes 2 weeks to see the results and often you can have soreness or headaches after botox injections. I suggest giving it two weeks and seeing what the results are then.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

4 days after botox

Dear susanne77,
You are very likely noticing swelling and tenderness from the injection which should resolve over he next week. You could also have a tiny hematoma that could also bruise a little as it resolves. Your Botox can take up to 10 days to kick in, and just FYI the dose used was quite small so I wouldn't be surprised if you need more. You kind of get what you pay for, and being stingy on the dose isn't always worth it.
Best of luck,

Stacey Folk, MD
Denver Plastic Surgeon
4.8 out of 5 stars 24 reviews

Muscle Soreness & Movement After Botox

Botox typically takes 7-10 days to achieve maximum effect.  The average dosage for #botox in the glabella is 20 to 24 units depending on the strength of you muscle.  The soreness you feel may be related to a small bruise.  You may consider Tylenol or an NSAID for the discomfort.

Please revisit with your injector in 7-10 days for further evaluation.

Best of Luck,
Suneel Chilukuri, M.D.
Houston, TX

Suneel Chilukuri, MD
Houston Dermatologic Surgeon
5.0 out of 5 stars 31 reviews

Botox injection for 11 lines

Thank you for your question.

It is likely that your discomfort is due to a hematoma which should resolve in 7-10 days. It is likely that it is in the muscle itself, otherwise you would have noticed an extensive bruise in the skin. Taking low dose ibuprofen will help resolve the problem sooner, along with some bromelain. 

Read my book about bromelain on the link below. It is a free access book. Look under the ebook section of my website. 

Dr Karamanoukian

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

Corrugator muscles sore & seem more prominent/tensed after recent Botox. Is retreatment necessary? How long until it improves?

Hello Susanne77,

The soreness is likely related to the injection and trauma to the muscle.  That should improve with time.  The tenseness likely is related to a deep bruise.  At 4 days after treatment, most people would not see any effect of treatment.  You will reach your maximum effect in about 7-10 days after treatment.  If you still have more motion than you want at that time, then I would recommend retreating.

You can discuss all of this with your injector but at this point, I wouldn't worry.  

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Wait 2 weeks for Botox results

It can take 1-2 weeks prior to seeing relaxation of muscles after Botox treatment.  Please be patient. 

It is odd that your muscles feel tense and more noticeable; perhaps you have a small hematoma from the needle poke.  If the bruise is deep, you may not see discoloration. You might ask the RN if she noticed more blood than usual when she withdrew the needle.

Melissa Chiang, MD, FAAD
Houston Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Time and dose

1) It may take up to 2 weeks for the Botox to kick in
2) 14 units in underdosing what is typically recommended for the corrugators. In my practice patients typically receive 20-32 units in the glabella.  If you still don't notice improvement, you probably will need more units.  As for the soreness, it may be from the needles or the Botox kicking in.

Jason Brett Lichten, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 18 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.