Botox Dosing by Tina Frizner, NP-C
Like snowflakes, we are all unique individuals. The same applies to determining the appropriate Botox dosing. If you have ever performed a basic Google search on “how much botox do I need?”, you’ve probably come across dozens of photos like these with a wide range of suggestions on the amount needed for each treatment area:
The goal is to find the minimum dose for your aesthetic. Some people like to merely soften lines, while others prefer that “frozen” look. Your treatment will be based on your goals and your anatomy every visit.
Allergan, the manufacturers of Botox, report some people may begin to observe decreased muscle movement as soon as 24 to 48 hours post injection, with the peak effect being about 2 weeks after treatment. The duration of treatment is generally 3 months. However, it is important to address that movement will be observed gradually as the product wears off between its peak and month 3. This is normal! There have been many times where patients come back into the clinic reporting Botox isn’t working for them any longer. They are usually unhappy with the amount of movement they observe between weeks 8-12. When we review the treatment history together, many times we see that the dose just needs to be increased. Allergan’s studies show a 90 day duration of Botox based on the treatment recommendation of 64 units. That includes 20 units in the glabellar lines (11’s), 24 units in the lateral canthal lines (crow’s feet), and 20 units in the forehead lines associated with frontalis activity.
There are a rare few who develop antibodies to Botox, and it simply stops being effective. However, this is linked to extremely high doses or increased frequency, meaning less than 90 days apart. That being said, let’s take an common example we see in clinic. A patient reports observing too much movement in the frown lines 8 weeks after treatment. In reviewing her
history, we see that she that she has been treated with 15 units of Botox and averages visits to the clinic every 8 weeks. Increasing the dose to 20 units will not only help prolong the duration of the Botox, it will also help prevent antibody formation, and save you money. Let me explain:
● 15 units every 8 weeks = 6.5 treatments per year. 15 units x 6.5 = 97.5 units ($975)
● 20 units every 12 weeks = 4.3 treatments per year. 20 units x 4.3 = 86 units ($860)
We always reconstitute our Botox per Allergan’s guidelines. Every. Single. Time. It may take a couple visits to find your perfect dose as everyone is different and beautiful, like a snowflake.