The average number of Botox units I use to treat the glabellar frown lines (the so-called “11’s”) is 20 units. For most patients, the effects begin to show within 48-72 hours.
Some patients may get the same results with less Botox, other patients require slightly more.
I caution patients to wait at least 3-4 days before judging the outcome.
If the level of paralysis or areas of paralysis are insufficient at that point, I will re-examine the patient to see whether a “touch-up” injection will be beneficial, but I usually wouldn’t administer an additional dose of the Botox until one week after the first dose. (Athleo Louis Cambre, MD, Los Angeles Plastic Surgeon)
The glabella is typically treated with 20units of Botox to relax efficiently. That being said, some patients do require slightly more units and some require slightly less depending on muscle mass, movement, etc.
20 Units Botox For Glabella
Keep in mind that getting “rid” of the lines completely may not be possible with Botox alone, especially after one treatment. Once those lines have become static, or ‘etched in’ so-to-speak, they require continued treatment of every 3-4 months.
You will begin to notice a marked reduction in the depth after 3 or so treatments. If you are still not satisfied with results, you may want to consider using a filler in the area. (Supriya Tomar, MD, West Palm Beach Dermatologic Surgeon)
I personally use 25 units for women in the glabella area and more for men. But many doctors use 20 units, so this is perfectly proper.
Of course, exactly where along the muscles the Botox is injected makes a big difference. (George J. Beraka, MD (retired), Manhattan Plastic Surgeon)
The amount of Botox injected in that area is normally around 20 units. Botox works by blocking the receptors in the muscle, so it doesn’t respond or contract.
These receptors need at least 4 days to bind to the Botox. If after 7-10 days, it doesn’t look better, call the doctor for a touch up. (David A. Dreyfuss, MD, Orland Park Plastic Surgeon)
How many units are needed for the “11” lines?
The proper amount of units of Botox to use for the glabella, commonly referred to as “11” lines, depends on the individual. The stronger your muscle the more units you will need. The average for women is 15-25 units.
You will also not see the effects of Botox until up to 5-7 days after you get injected. Men will need more units as they have more muscle mass. It is important that you trust who is injecting you.
It is always a good idea to get a second opinion and consult with a board certified plastic surgeon. (N. Bill Aydin, MD, Paramus Plastic Surgeon)
Botox dosing
For the glabella I generally inject between 15 and 25 units depending on the severity of the glabellar creasing. (John L. Burns Jr., MD, Dallas Plastic Surgeon)
The amount of Botox, or neuromodulator, required for the glabella to address the 11’s varies between patients, depending on the thickness of the muscle there and how dynamic the muscles are. In general, I start with 20 units for woman and 30 units for men.
For patients who are new to me, I see them back after two weeks to determine if there is still dynamic motility there and that I need to place more neuromodulator. (Laura Phan, MD, Los Gatos Physician)
Doctor Joel Schlessinger, MD, Omaha Dermatologic Surgeon – Female Treated For Glabella And Wrinkles On Forehead
An average dose for the glabella or “11’s” is 20 units, but for patients with very deep and strong muscles more may be needed. Follow up with your physician in 2 weeks so they can evaluate how you responded.
At that point the full effect of the botox can be seen, and should your muscles be very strong you may need a stronger dose. In the future, the physician can inject that adequate dose for you.
Medicine is an art, and every patient is very different from the next patient. Over time, both the patient and the physician understand how the Botox is working for the particular patient and which dose is best.
I always recommend my patients to be treated by a Board Certified Dermatologist. (Azin Meshkinpour, MD, MPH, FAAD, Lake Forest Dermatologist)
Glabellar Lines By Dr. A. H. Nezami, MD, Jacksonville Plastic Surgeon
Botox – when does it take effect?
Botox takes up to 10 days to take effect. The usual amount is 20 to 25 units for glabella. Some patients may do well with a little less and some need more . If your provider was experienced in Botox injections , you should be able to trust that he gave you the correct amount.
Physicians are not likely to “cheat” patients. They want you to have great results and come back . Botox lasts about 3 to 4 months. (Linda J. Banta, MD, San Antonio Dermatologist)
How much Botox is needed to alleviate “11” (glabellar) wrinkles
The amount of Botox needed for a specific response is patient dependent. The best way to determine the optimal amount (units) is by one’s previous Botox injections. Recommendations from Allergan’s FDA clearance, the manufacturer, is twenty (20) units of botox.
Glabellar Lines
However, in my experience, most patients (80%) require 25 units. Men usually require more than woman. I have never inject more than 35 units to reach full muscle relaxation. Unusual patients still have vertical creases after complete muscle relaxation.
Although this is an off-label use, fillers can be injected. However, injection in this area has a risk of blindness, so injection with a blunt microcannula, drawing back on the syringe before injection and injecting with minimal pressure is recommended.
Also, pre injection with lidocaine with epinephrine can decrease the size of the blood vessels (vasoconstriction). (Robert J. Troell, MD, FACS, Las Vegas Facial Plastic Surgeon)
Botox for Frown Lines
26 Year Old Latin Man Treated With Botox For Glabella Wrinkles (’11’s’) With Dr John Mesa, MD, New York Plastic Surgeon
Some people who have stronger muscles in this area may require more, but 20 units is a good starting point that will give many patients a great result. However, it takes at least 3-7 days after injection for patients to see any effects, and this effect will not reach it’s maximal result until 10-14 days after injection, so it is best to wait until that time before assessing the effectiveness of the treatment.
If you have not received an adequate result by that time, I would recommend that you get in touch with your provider to see if a touch-up may be indicated. This is very common practice, particularly for injectors who are treating a patient for the first time and do not yet know how they will react to a particular dose.
If you do require more than 20 units to achieve the desired result, your provider will be able to document that in order to treat you with the appropriate amount when the results of this injection wear off in 2-4 months. (Jordan Cain, MD, Frisco Facial Plastic Surgeon)