How Many Botox Units Do I Need?

How Many Botox Units Do I Need?

Although it’s often seen as a cosmetic-only treatment, Botox is actually a medical procedure. Like all medical procedures, the recommended dosage depends on many factors. What works for one patient may not work for another.

Luckily, the question “How many Botox units do I need?” isn’t something you typically need to worry about—your medical provider will prescribe your correct dosage. By speaking frankly with your provider about the results you’re looking for, you can work together to determine exactly how many Botox units you’ll need.

With that said, because Botox is often priced per unit, it can be helpful to know roughly how many units of Botox your visit will require. To that end, we’ve put together these guidelines on the typical recommended Botox unit requirements for popular treatments.

How Botox is Measured

Before we can fully explain how many Botox units you’ll need for any procedure, it’s important to discuss what a Botox unit is.

The active ingredient in Botox is called botulinum toxin type A. It’s a well-understood toxin that is completely safe and effective when injected in small, controlled doses. Don’t let the term “toxin” scare you; Botox has been used in the medical field for decades to treat facial spasms, reduce skin wrinkles, help with TMJ (pain or discomfort in the jaw joint) and more.

However, because the crucial ingredient in Botox is a toxin, controlling the amount used in any given injection is essential. To ensure a high degree of accuracy, professionals use the term “unit of Botox” to refer to the amount of botulinum toxin type A present. One unit of Botox corresponds to a specific amount of the active ingredient—not the total amount of liquid in a vial.

Sometimes, you may read somewhere or see that Botox treatments are measured in “syringes.” Take these guidelines with a grain of salt; Botox can come in vials of 50 or 100 units, so using “syringes” as a measurement isn’t as accurate as using units.

Finally, keep in mind that Botox is a brand name. Several other neuromodulators use the same biotechnology, such as Dysport and Xeomin. These options rely on the same active ingredient, but they can be more or less potent than Botox. As such, the number of units you’ll need may differ. Today, we’re focusing specifically on Botox units.

An Area-by-Area Guide to Botox Units

Now that you understand what a unit of Botox is, it’s time to look at how many units you may need. Once again, keep in mind that these guidelines are rough estimations based on the average number of units used for each treatment area. Depending on several factors (which we’ll touch upon shortly), your requirements may vary.

Here’s the amount of Botox you might expect your provider to recommend for the following treatments:

  • Forehead lines – The long, horizontal lines that can crease your forehead typically take 8 to 20 units.
  • Frown (glabellar) lines – Known as the “11” lines that can appear between your eyebrows usually require 20 to 30 units.
  • Eyebrow lift – When using Botox to bring about a slight lift in the eyebrows, you’ll generally need 2 to 5 units per side.
  • Crow’s feet – These small wrinkles in the corners of your eyes can be smoothed out with about 9 to 14 units per side.
  • Bunny (nasalis) lines – The tiny lines that show up on the bridge of your nose when you smile or wrinkle your nose can be treated with 4 to 10 units.
  • Masseters (jaw slimming) – Your masseter muscles sit between the ear and mouth and can contribute to jaw pain and discomfort. Treating this area (whether for TMJ relief or facial contouring) requires anywhere from 15 to 50 units per side.
  • Lip lines (perioral lines) – known as “smoker lines” 4 units.
  • Lip Flip4 units
  • DAO – These vertical lines are located between the corners of the mouth and chin. They can cause a downturned mouth – 2-6 units per side.
  • Mentalis (Dimpled chin) – Reducing the dimples that appear across your chin is possible; all it takes is 4 to 15 units of Botox.
  • Neck (platysmal) bands – Vertical necklines or “bands” that can appear on the neck over time. With 20 to 40 units, you can soften the appearance of these bands while giving your neck a more youthful look.
  • Underarms – Aside from its cosmetic uses, Botox is also indicated as a treatment for excessive sweating (hyperhidrosis). This treatment calls for 100 units.

Factors That Can Affect the Number of Botox Units You Need

As you may have noticed, there’s a substantial gap between the lower and upper limits for many of the above treatments. That’s because every patient is different; it’s hard to know how many Botox units you’ll need until you book a consultation with a medical provider.

Depending on the factors below, your treatment requirements may be at the bottom, middle or top of these ranges—or even beyond them. However, note that the Botox label specifies that the cumulative dose should not exceed 360 total units administered over a three-month span.

Muscle Size and Strength

The most important factor for gauging the required amount of Botox units is muscle size and strength. After all, Botox works by blocking the signals from your nerves that cause your muscles to contract. If the targeted muscles are larger or stronger than average, you may need more units to convince those facial muscles to relax. On the flip side, weaker muscles may require fewer units overall.

Muscle size and strength can differ from person to person for several reasons. Some are due to genetics; others are based on day-to-day habits. For instance, something as simple as regularly chewing gum could cause your masseter muscles to become bigger and stronger. Other facial muscles that are affected by ordinary movements, include:

  • Smiling
  • Frowning
  • Squinting
  • Laughing
  • Pursing or puckering the lips

Age

Your age impacts the size and strength of your facial muscles, but it also plays other roles in determining how many Botox units you’ll need.

As we age, our skin naturally becomes thinner, less plump and less smooth due to volume loss. Wrinkles also become more pronounced over time.

With that in mind, if you receive your first Botox treatment at 65, you may need more units to diminish deeper lines than if you were 25. For this reason, more and more patients are starting Botox treatments at a young age.

Sex

As a general rule, men tend to require more Botox units than women for the same treatments. The reason is simple: Genetically, males tend to have bigger and stronger facial muscles than females.

Of course, there are always exceptions, but we tend to use more Botox with our male patients.

Metabolism

Just as your body’s metabolism processes incoming calories, it also processes Botox. As such, if you have a high metabolism, your Botox treatment may not last as long. To combat the effects of a high metabolism on injected Botox, your provider may suggest using additional units to extend the amount of time between treatments.

Desired Results

Finally, your exact Botox requirements will depend on your cosmetic goals. If you want that ultra-smooth look, you’ll generally need more Botox units to achieve it. If you’d rather maintain a complete range of facial movement, you and your provider might opt for a smaller dose.

While you can use this guide as a baseline, the only way to know exactly how many Botox units you’ll need is to speak with a professional. Your provider will listen to your concerns and goals, ask questions about your health history and present you with different options that suit your needs and budget. Through regular consultation—and a follow-up appointment two weeks after your first injections—these dosages may be adjusted to provide even better results.

At Derma Health Skin & Laser, our amazing staff is here to walk you through the Botox injection process from start to finish. All of our injectors and aestheticians go through advanced education and training to ensure you leave feeling satisfied with your outcome and results.

If you want to find out how many Botox units you’ll need—or if you have any other questions about Botox treatment—we encourage you to schedule your consultation today.

Sources: 

American Society of Plastic Surgeons. Botulinum Toxin. https://www.plasticsurgery.org/cosmetic-procedures/botulinum-toxin

National Center for Biotechnology Information. History of Botulinum Toxin Treatment in Movement Disorders. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5133258/

Botox Cosmetic. BOTOX® Cosmetic (onabotulinumtoxinA): Dosage | Dilution | Reconstitution. https://hcp.botoxcosmetic.com/~/media/Unique%20Sites/BotoxCosmeticHCP/Files/PDFs/Dilution_Reconstitution_Injection_Guide.pdf

FDA. Botox Label. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/103000s5232lbl.pdf

Mayo Clinic. Botox injections. https://www.mayoclinic.org/tests-procedures/botox/about/pac-20384658

PMFA Journal. Management of masseter hypertrophy and bruxism with Botulinum Toxin A. https://www.thepmfajournal.com/features/features/post/management-of-masseter-hypertrophy-and-bruxism-with-botulinum-toxin-a

National Institute on Aging. Skin Care and Aging. https://www.nia.nih.gov/health/skin-care-and-aging

Derma Health Skin & Laser. Botox® Cosmetic For Fine Lines & Wrinkles. https://dermahealthinstitute.com/treatment/botox/

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