Have you ever wondered about your recommended Botox dose? How did the injector get to that unit number? You’re not alone. We often get calls from people asking for an estimated dose so they can get a read on their treatment price; we can relate. While you may find FDA-approved dosing guidelines online, it’s not always clear how those numbers relate to you personally. We’ll break it down so you can feel confident and informed before your next treatment.
How FDA-Approved Botox Doses Came to Be – and Why They Matter
When Botox was first developed for cosmetic use, the company, Allergan at the time, now AbbVie, completed preclinical and clinical trials to determine the optimal dosage based on several factors: effectiveness, safety, and longevity, for the majority of their clinical volunteers. Then, they submitted a New Drug Application (NDA) to the FDA to get approval. Ensuring the benefits outweigh the risks and reviewing safety and efficacy, Botox was approved for cosmetic use in 2002, making it the first neuromodulator for wrinkles on the market. As time passed, Botox gained approval for three additional areas.
FDA Approval Timelines for Botox
- Glabellar lines (frown lines between the brows) – approved in 2002
- Crow’s feet – approved in 2013
- Forehead lines – approved in 2017
- Platysmal Bands in the neck – approved in 2025
At this time, Botox is the only neuromodulator brand to receive FDA approval for four treatment sites. Other brands soon followed suit to get on the market: Dysport (approved in 2009 for glabellar lines), Xeomin (approved in 2011 for glabellar lines), Jeuveau (approved in 2019 for glabellar lines), and Daxxify (approved in 2022 for glabellar lines). And, all but one, Xeomin settled on that one FDA approval for the indication of glabellar lines; Xeomin just received FDA approval for simultaneous treatment of forehead lines, crows feet and glabellar lines in 2024. Likely, cost, time, and return on investment were factors for the other companies hoping providers would use their product “off-label” in the other areas based on the prior approvals of Botox in these areas. And, so far, that has been the case for the majority of providers.
FDA Doses versus Your Botox Doses
The important thing you should know: Botox’s FDA-approved doses aren’t meant to be a “one-size-fits-all.” They’re a baseline, not a mandate. Your ideal dose may be adjusted up or down based on your muscle strength, facial anatomy, aesthetic goals, and how you’ve responded to Botox in the past. A skilled injector uses the FDA guidelines as a starting point, then personalizes your plan to fit you.
Glabellar Lines (the 11’s between the brows)
The FDA-approved dose for treating glabellar lines is 20 units (spread across 5 injection sites at 4 units each). In everyday practice, most providers use between 20–25 units. At Aluma, we find this is an area where a stronger approach often works best. The glabella is primarily made up of depressor muscles that pull the brows inward and downward, creating a tense, furrowed look. Over time, this repeated motion can deepen lines between the eyes and contribute to forehead tension. For most people, the FDA-recommended dose delivers excellent results—and since no one wants to look angry when they’re not, “freezing” this area is usually well-tolerated and doesn’t look unnatural.
Forehead Lines (Frontalis)
The FDA-approved dose for forehead lines is 20 units, though in practice most patients receive closer to 10–15 units. This is one of the trickiest areas to treat with Botox because the frontalis muscle varies significantly from person to person and works in balance with the glabella muscles. Using too high a dose can create a heavy or drooping brow, while going lighter may mean the effects wear off more quickly or forehead lines persist. At Aluma, we typically lean toward the lighter approach so our patients’ foreheads are smooth at rest but still have some movement with expression. Overall, we feel it is a more natural and refreshed look compared with the overtreated forehead that is “frozen,” meaning it doesn’t move at all and often has a shiny appearance.
Crow’s Feet (Lateral Canthal Lines)
For crow’s feet, the FDA-approved dose is 24 units (12 per side), though in practice most patients receive between 5-10 units per side. While higher doses can soften lines more dramatically, they may also increase the risk of undereye puffiness in some people, since the surrounding muscle activity is important for lymphatic drainage. At Aluma, we prefer a lighter touch in this area—keeping some natural movement allows the eyes to stay bright and expressive while still softening unwanted lines.
Platysmal Bands/ Nefertiti Lift
The FDA-approved dose for treating platysmal bands and the jawline area is 36 units, though in practice we typically use around 30 units, depending on how many bands need to be treated. This treatment relaxes the vertical neck bands and the depressor muscles along the jawline leading to improved jawline definition, decreased neck wrinkles, a subtle boost in cheek volume, and an overall more lifted appearance. While not as commonly requested as forehead or crow’s feet treatments, it can make a remarkable difference for patients seeking a more elegant neck and jawline contour.
Botox For the Entire Face
With the recent FDA approval for treating platysmal bands, AbbVie has leaned into marketing Botox as a “full-face treatment,” encouraging patients to consider one full vial (100 units) per session. The math comes from adding the FDA-approved doses for the major areas: frontalis (20 units), glabella (20 units), crow’s feet (24 units), and platysmal bands (36 units), totaling 100 units.
Some providers now offer package pricing when patients purchase and inject an entire vial in one visit. At Aluma, we take a different approach. In our experience, most clients don’t actually need the maximum FDA-approved doses in all four areas. Instead, we focus on tailoring Botox treatments to each face—prioritizing a natural refreshed appearance—rather than a one-size-fits-all dosing model.
What About Botox for Other Areas?
While Botox is FDA-approved for only a handful of treatment areas, the approval process is both lengthy and costly. That’s why many experienced providers also use Botox off-label—applying their training and clinical judgment to treat additional areas of the face and body. These off-label uses are common, safe in skilled hands, and can deliver beautiful, natural results.
Here are a few popular examples:
- Trap tox (relaxes the trapezius muscles to ease shoulder tension and elongate the neckline): 40–60+ units
- Bunny lines (wrinkles across the nose when smiling): 4–6 units
- Lip flip (adds subtle lip projection and shape): 4–6 units
- Gummy smile (reduces gumline show when smiling): ~2–4 units
- TMJ/jaw clenching (relieves jaw tension and may slim the face): 30–40 units
Our Take on Off-Label Botox Treatments at Aluma
At Aluma, we see some patient’s requesting treatment for bunny lines and lip flips. Results can vary—some patients notice a nice enhancement, while others don’t see much change. If your goal is noticeable lip volume and projection, lip filler is usually a better option than a lip flip.
Gummy smile treatment is one of the most loved off-label uses. It requires only a few units and can deliver a beautiful, natural smile with less show of the upper gums. However, results depend on your anatomy, so it’s important to consult with your provider to make sure it’s the right fit for you.
Masseter Botox (for jaw clenching, TMJ pain, or teeth grinding) is another popular treatment. It’s highly effective for reducing pain and tension, and with repeat treatments, it can also slim the jawline. While that may be a plus for some, patients with naturally slim faces—or those concerned about jowling—should approach this treatment thoughtfully. The masseter muscles provide some support to facial tissues, so reducing them too much can lead to less structure over time.
Trap tox (Botox in the trapezius muscles) can be helpful for patients who carry a lot of stress and tension in their shoulders. It may also create a longer, more elegant neckline. However, it tends to be costly, and because weakening these muscles can cause your body to compensate with others, we don’t generally recommend it unless you’re experiencing significant tension.
The Many Wonderful Uses of Botox
While FDA-approved doses provide important safety guidelines, real-world Botox treatments are rarely “one size fits all.” Every face is unique, and an expert provider tailors dosing to your individual anatomy, goals, and lifestyle. Whether you’re addressing forehead lines, crow’s feet, a gummy smile, or jaw tension, personalized treatments lead to more natural, harmonious results than simply following the maximum FDA-approved units. Choosing a skilled provider who understands both the science and the art of Botox ensures you get safe, effective, and beautiful natural results.
Ready to explore the possibilities for your own face? Visit Aluma Aesthetic Medicine to schedule a consultation and experience Botox tailored specifically to you.
