So you got your Botox…but it’s not quite looking how you wished. Needing a Botox touch-up is completely normal, and even expected—especially when you are addressing a new area, or working with a different injector! This is because knowledgeable injectors know they need to see the medication’s effects on your anatomy. And while they can always add units of neurotoxin, they can’t take them away.
Still, it can feel frustrating and even stressful to talk to your injector about wanting changes. We assure you that qualified, experienced medical injectors will be ready to listen and encourage you to call to ask for a touch-up, no matter how minor your issue. Below, we explain why and how to ask.
What is a Botox touch-up?
A Botox touch-up typically uses a few units to tweak your results, rather than the more dramatic number of neurotoxin units needed for a full treatment. A true “touch-up” to refine existing results is most often done if you have not reached your desired outcome for facial wrinkle treatment by about 2 weeks post-treatment. This is because, while neurotoxin acts within a few days, it takes a few weeks for expression-based wrinkles to relax out of the skin. This is true whether you use Botox, Dysport, Jeuveau, Xeomin, or Daxxify brand neuromodulators.
How often do you need to touch up Botox?
To maintain your desired Botox results, full treatment appointments should be spaced 3-4 months (12-16 weeks) apart for most areas, or up to every 8 weeks for a Botox lip flip (an area where neurotoxin more rapidly wears off). However, if you don’t see your desired results two weeks after your appointment, you may want to schedule an extra touch-up with your injector, as this may be a sign more product (and potentially additional injection sites) are needed to achieve your desired results.
A true Botox “touch-up” is most often done if you have not reached your desired outcome by about 2 weeks post-treatment.
How do I know if I need more Botox?
First, it’s key to wait 2 weeks after your initial Botox appointment to see how your results develop; if you are still able to see some movement and form the facial expressions that create the targeted dynamic wrinkles in your face, then you may need a touch-up, adding a few additional units to the same sites.
Keep in mind that the best Botox results come from achieving a pleasing balance of muscular movement; if you only treat the ‘11s’ between your brows, for example, other facial muscles may overcompensate for the change, leaving you with more noticeable wrinkles elsewhere. Thus you may need to treat additional spots to achieve a desirable, overall-youthful look. In this case, a “touch up” may actually mean adding on full treatment of new areas such as the crow’s feet or upper brow.
It is also common to need a few more units to improve symmetry. This is because, with your first treatment, your injector may want to inject neurotoxin in a fairly symmetrical pattern, and then see how the product acts on your individual anatomy and adjust accordingly. (While no face is perfectly symmetrical, Botox can often improve symmetry of key features such as the eyebrows.)
If you want to get a better sense of the total number of Botox units you might need ahead of time, it’s a good idea to ask your injector what to expect, in detail, at your first appointment. Your questions might include: What is the best area to treat first? How many units are safe to start with? How many units do patients like me usually want in total? Their answers will help you to develop realistic expectations.
Reasons a Botox injector may use “too little” neurotoxin
Here are some scenarios where your injector may choose to use a light touch:
- You’re a first-time patient: If you haven’t had neurotoxin injections before, injecting with a light touch allows us to see how your body responds to treatment without over-treating.
- It’s their first time injecting you: As with first-time patients, if an injector is working with you for the first time, they may want to err on the side of caution.
- You want natural-looking or more masculine results: Some patients want results that aren’t super smooth, but rather a conservative, natural-looking reduction in movement that results in somewhat smoother wrinkles in the treatment area. To accomplish this, your injector will inject on the lower side of the units normally needed for an area.
- Preventative “baby” Botox: Younger patients looking to preemptively stop wrinkles before they form may opt for light or “baby” Botox injections.
Touch-ups are to be anticipated, and it is simply best practice to inject with a light touch as an injector gets to know your features and your response to Botox. This allows us to avoid over-treating with Botox, which can lead to eyebrow ptosis (sagging), among other complications.
Considering how common injection touch-ups are, consider booking a 2-week follow-up evaluation appointment so your injector can see how your results developed and provide adjustments. We often encourage our patients to do so!
Continuity of care with your injector
To help ensure you get the best results, it’s a good idea to find an injector you trust and continue to see them for continuity of care. This way, your injector gets to know your anatomy and how you respond to injections, and can ultimately provide the very best results—including touch-ups, as needed.
Are Botox touch ups free?
Typically, Botox touch-ups are not free. If you need a few more units of a Botox-type injectable to see desired results, most injectors will charge by the unit—so minor touch ups may cost anywhere from $50-$150, depending how much more product is needed.
That said, some medspas charge by the area (i.e. the forehead), and thus may not charge for a touch-up to that area. While this may sound advantageous, we believe it is best to pay for neurotoxin by the exact number of units you need for treatment. This is because every patient needs a different treatment plan, and pricing by the unit ensures you get exactly the amount of product you have paid for.
In contrast, pricing by the area may encourage undertreatment or be a sign of cookie-cutter treatment plans; you may also be surprised if you are told a related area that is necessary to achieve good results is “outside” of what was included and will incur extra costs.
How do I ask my injector for a touch-up?
Call the medical spa, dermatology practice, or cosmetic surgery practice where you received your Botox, and simply let them know that you don’t see the results you expected after your appointment. Experienced and qualified medical injectors are aware that it is normal for some patients to not see the full results they expected, often due to no fault of their own—it is normal to need a touch-up from time to time.
While it’s a good idea to be honest, you should also make sure you communicate in such a way that helps your injector understand what is needed to meet your goals, and why you’re dissatisfied:
- Remember that the need for a touch-up is not necessarily due to your injector’s fault, so use phrasing that avoids placing blame. Make your request neutrally, i.e.: “It’s been two weeks, and I think my Botox needs a bit more refinement.”
- Ask for extra time in the beginning of your appointment to discuss your desired changes with your injector. Less-than-perfect results can easily stem from miscommunication, so ensuring there is adequate time to express your desired goals may be especially helpful before a touch-up.
- Come to your appointment with an open mind! It’s possible that, after seeing how results developed, your injector will recommend a slightly different tactic based on their experience—trust the experts, rather than simply shopping for a certain treatment in a certain area.
At our Asheville medical spa, we are happy to discuss your options with you, at any stage after your injections with us. We are also happy to see you if you are dissatisfied with a previous injector’s results and want a second opinion.
Medical spa offering Botox in Asheville, NC
At Mountain Radiance, located just south of Biltmore Village in Asheville, NC, Dr. Mark Chandler and licensed RN nurse injectors Lindsay and Sarah are here to help you achieve the look you love with Botox, Juvederm dermal filler for improved facial volume, laser skin rejuvenation, and a range of aesthetician facials and other options. We strive to cultivate a no-pressure, friendly environment for Botox in Asheville. Call us at (828) 627-2711 or send us a message online to schedule your appointment (or touch-up!) today.
