Twenty units is a standard dose for the frown lines, or 11’s. This can help the forehead some, but the forehead as an additional area will take more doses of Botox.
My patients vary in their frown line (11’s) dosing. Some patients, and younger patients may prefer 5 units for each side or a total of 10 units. Others may need 15 units on each side. Certain patients have corrugator muscles that are very long and therefore need there Botox carefully spaced out to catch the lateral recruiters that will make a frown even if the central area is weakened.
The strongest parts of the frown muscle are near the center and I place more there, but small doses laterally can also be necessary. The central vertical wrinkles are from the procerus muscle and this often needs some small doses of Botox.
37 Year Old Woman Treated With Botox With Dr Don W. Griffin, MD, Nashville Plastic Surgeon
The maximum effect is at about 10 to 14 days and then is slowly wears away over months. At day one there is usually no effect. In addition, deep frown lines may need careful placement of some Juvederm to correct the loss of volume as the crease may continue to be there, even if the frown muscles are severely weakened.
A careful exam and discussion with your doctor will help you achieve the results you wish. And repeat dosing at 3 to 6 months will be necessary as you body metabolizes the Botox. Make sure you have confidence in your physician so you don’t feel “cheated” in any way. (Keith Denkler, MD, Marin Plastic Surgeon)
The glabella area can usually be treated with 20 units of botox but may require more if the muscles are particularly strong. Also some wrinkles are etched in and botox may never work on them. A board certified plastic surgeon or dermatologist will usually be honest and set proper expectations.
39 Year Old Woman Treated With Botox With Dr Suzanne Kilmer, MD, Sacramento Dermatologic Surgeon
Trying to treat the glabella and forehead with only 20 units of botox is bound to fail. (Avron Lipschitz, MD, Stuart Plastic Surgeon)
There are numerous variables that can determine the amount of botox required (number of units) including severity of lines, age of the patient, and gender (men usually require more), as well as reconstitution of product.
Specific consensus guidelines have been published and many patients 20 units of Botox would be appropriate (often considered the median dose for glabella). Proper consultation with an expert board-certified dermatologist would ensure that you will get the most ideal treatment that is specifically tailored to your face! (Andrei Metelitsa, MD, FRCPC, FAAD, Calgary Dermatologic Surgeon)
Treatment of the 11s or vertical frown lines in the forehead is probably my favorite area to treat with Botox. We call this area the glabella. In women I usually start with 20 units which is sufficient most of the time.
Botox Cosmetic With Dr. Kelly Gallego, MD, FACS, Yuba City Plastic Surgeon
Some women need 25 units for best results, but I rarely need to go higher than that in females. Men are a different ballgame and often need more units because their muscles are stronger. I tell my pateints to give it 1-2 weeks to fully kick in.
If a patient of mine is not 100% satisfied, I want them to come back to the office so that I can take a look. Sometimes I will give a small touch up injection if needed at no additional charge to get the best possible result.
Overall I would say that my philosophy with Botox is to be conservative and not overtreat. Most of my patients want natural-looking results and don’t necessarily want to look frozen. It’s easy to add more if needed, but you can’t take out what’s been injected. (Richard Ort, MD, Lone Tree Dermatologic Surgeon)
Number of Botox Units
The number of units to treat frown lines in unique to each patient depending on the severity of their fine lines and wrinkles and their aesthetic goals. It requires approximately 3 to 5 days to begin to see visible results with a peak effect at 2 weeks post treatment.
I generally use 20-25 units to treat the glabella or frown lines. There are some patients who may require supplemental hyaluronic acid filler to fill in a permanent crease if the creases remain after adequately relaxing the muscles that cause these lines. (Scott Chapin, MD, FACS, Philadelphia Plastic Surgeon)
Units for the 11’s of frown lines
20 Units is a good dose for the frown lines. There is some variation with stronger or weaker muscles that might require slightly more or less but in general you will get a great result with that dose.
Glabellar Lines – 63 Year Old Female With Dr Jacque P. LeBeau, MD, Pensacola Facial Plastic Surgeon
It does take time to see the results, so wait a full week before you decide if you need a touch up or an additional procedure. Very deep or etched lines in this area might require a small amount of filler after the botox.
Laser resurfacing can also help smooth the lines. (Myriam Loyo, MD, Portland Facial Plastic Surgeon)
I inject anywhere from 10 – 30 units in the glabella depending upon the strength and thickness of the glabella muscles.
If the lines are etched and deep, I usually inject with Botox and see the patient back in 2-4 weeks and then inject a 1/2 syringe of filler.
I inform the patient, however, before treatment if this combination would deliver optimal results so there are not unrealistic expectations from Botox treatment alone. (T.G. Khan, DO, FACS, Fort Lee Oculoplastic Surgeon)
Achieve The Best, Most Natural Looking Results
How much Botox for 11’s – It Varies
Your Botox provider should provide a no pressure complimentary consultation and you will get an idea about how much Botox will be needed to achieve your specific goal.
When in doubt, it is best to be conservative and come back for more. (Michael Law, MD, Raleigh-Durham Plastic Surgeon)
It takes at least 3 days before you start to see a result and 7-10 days to reach the maximum effect. 20 units is a good starting dose for the 11s. In some cases it can take up to 50 units, but 20 units work for most people. (William Marshall Guy, MD, The Woodlands Facial Plastic Surgeon)
Botox typically takes 5-7 days to take effect, and we recommend waiting at least 10 days before any touch ups to ensure the botox has taken full effect.
The number of units injected to the “11” lines depends on how strong your muscles and movement are. 20 units is typically recommended but sometimes more or less units are used depending on how much movement is present. (M. Bradley Calobrace, MD, FACS, Louisville Plastic Surgeon)
I counsel patients that you may start to see results in 3 days, and the full effect occurs in 1-2 weeks. The average dose of Botox for the Glabella (frown lines) in my practice is 20 units.
However, experience is helpful to tailor the dose. Some patients get outstanding results with 12 units, some of my male and migraine patients routinely need 28 units. Experience matters! Clinical judgement is not a commodity. Seek someone with lots of Botox experience and someone that you trust. (Luke J. Curtsinger, MD, Savannah Plastic Surgeon)
How much Botox for Glabella and brow
When considering Botox to the Glabella (region between the eyebrows) and the Forehead there are several things to consider. First, chose a reputable doctor. Plastic surgeons, dermatologists, and ENT facial plastic surgeons usually have the most experience with Botox and are adept in helping you achieve the look you want.
Second, it generally takes between 5-7 days to see the effects of Botox injections. Give the Botox time to do what it is supposed to do. Lastly, 20 units of Botox may not be enough to resolve heavy lines and if the muscles in that area are larger and more active than average, then more Botox may be necessary.
I usually suggest at minimum 12-14 units for the Glabella and10-14 units for the brow. Also, if the lines are long standing, they may not resolve completely and may only show improvement. (Joel M. Stewart, Jr., MD, Newnan Plastic Surgeon)
Botox to 11 Lines
Usually it takes more than a few days to see the effect of Botox. Usually it can take 7-14 days. Many people start with 20 Units of Botox for the glabella or eleven lines. In some patients, more botox is needed to achieve the desired effect. (Jean Keamy, MD, Westborough Ophthalmologist)
The average number of units used to treat the glabellar complex (11’s) of a female patient is 20 to 25 units.
It is always better to be conservative with a new patient and to under-correct than to over-correct. I always see my new patients at 2 weeks to evaluate the effect of the Botox injection and provide any “touch-ups” that may be needed to optimize the results of the Botox. (E. John Serrao, MD, Orlando OB-GYN)
Botox results typically take 1-2 weeks to appear and not much will happen the day after the injection, so be bit patient to see the true outcome. (Anatoli Freiman, MD, Toronto Dermatologist)