Botox Dosage per Area: A Professional’s Guide

Botulinum toxin type A (Botox® Cosmetic, Allergan/AbbVie) remains the most frequently performed nonsurgical cosmetic procedure worldwide. Over 4.4 million Botox treatments were administered in the United States in 2020 alone.¹

Botox currently holds FDA approval for the treatment of glabellar lines, forehead lines, and lateral canthal lines.² Many off-label applications, such as platysma band reduction and masseter contouring, are also widely practiced. 

Each indication requires a specific, evidence-based Botox injection dosage protocol to achieve optimal results. 

This article provides a comprehensive overview of Botox dosage by area, with practical, clinically relevant recommendations. 

Key takeaways

• The maximum safe cumulative dose of Botox is 400 units within a three-month interval. 
• Forehead lines must always be treated in conjunction with glabellar lines for brow balance. Use a combined FDA-approved dose of 40 units (20 units for frontalis and 20 units for glabellar complex).
• Lateral canthal lines (crow’s feet) are treated with a total of 24 units, with 4 units per injection at three sites per side.
• For platysmal bands, you need 26-36 units, depending on the number of bands.
• Masseter muscle treatments (off-label) use 20-30 units per side across two sites per masseter, with a total of 40-60 Units.

Botox Recommended Dose Guidelines by Area

Botox dosing is not uniform and differs based on the anatomical area and muscle mass. Smaller facial muscles need lower doses, while larger or stronger muscles require higher dosing.³

Here are the recommended Botox dose ranges for each treatment area.

Dosing for Glabellar Lines

The glabellar complex, composed of the corrugator supercilii and procerus muscles, is the most commonly treated area with Botox. The FDA-approved on-label dosage for the treatment of moderate to severe glabellar lines with onabotulinumtoxinA (Botox, Allergan) is 20 units administered across five injection sites.⁴

Here is the breakdown:

• Corrugator supercilii. 4 units (0.1 mL) per site, injected into two points on each corrugator (total 16 units).
• Procerus muscle. 4 units (0.1 mL) injected into a single central point (total 4 units).

The standardized dosing makes a cumulative volume of 0.5 mL (20 units) when reconstituted at 100 units/2.5 mL.

Dosing for Forehead Lines 

The treatment of horizontal forehead rhytids involves targeting the frontalis muscle. It is the only elevator of the brows, which acts in opposition to the glabellar complex. 

Because of this antagonistic relationship, dosing for the forehead must always be performed in conjunction with glabellar line treatment to maintain brow balance. 

Botox dosage in this case is a total dose of 40 units distributed across both the forehead and glabellar complex:

• Frontalis muscle (forehead lines). 20 units divided into five injection sites at 4 units (0.1 mL) each. These sites are placed in the upper third of the forehead, at least 1.5-2 cm above the orbital rim, to minimize the risk of brow ptosis.
• Glabellar complex. 20 units divided into five injection sites (four in the corrugators and one in the procerus) at 4 units (0.1 mL) each.

It results in a cumulative dose of 40 units (0.1 mL × 10 sites), administered with a reconstitution of 100 Units/2.5 mL.⁵

The product should, however, be evenly distributed across the central and lateral forehead to avoid patchy paralysis or “Mephisto sign” (lateral brow over-elevation).⁶

Dosing for Lateral Canthal Lines

Lateral canthal lines, commonly known as crow’s feet, are formed by repetitive contraction of the lateral fibers of the orbicularis oculi muscle. It is a sphincter muscle that contributes to dynamic wrinkles at the outer canthus during smiling and squinting. 

The FDA-approved Botox dosage for lateral canthal lines is 4 units (0.1 mL) into each of three sites per side. It results in a total of 12 units per side and 24 units overall when both sides are treated.⁵

The cumulative injection volume is 0.6 mL when reconstituted at 100 Units/2.5 mL. The recommended injection depth is intramuscular, placed in the lateral orbicularis oculi fibers 1-1.5 cm lateral to the orbital rim.

Dosing for Platysma Bands

Prominent platysmal bands are a common feature of cervical aging. They are caused by hyperactivity and laxity of the platysma muscle.

Botox dosage for prominent platysmal bands is based on the number of bands requiring treatment:⁵

• One vertical band per side. 26 units in 0.65 mL (18 total injection sites).
• One band on one side and two bands on the opposite side. 31 units in 0.78 mL (23 total injection sites).
• Two bands per side. 36 units in 0.9 mL (28 total injection sites).

The dosing is distributed between the upper platysma and the vertical bands. For the upper platysma, just below the jawline, the protocol is to inject 0.05 mL (2 units) into four sites per side. For the vertical bands, 0.025 mL (1 unit) is injected into five sites per band per side. 

The recommended injection depth is superficial intramuscular. Deep placement should be avoided to reduce the risk of dysphagia, dysphonia, or diffusion into the strap muscles. 

Botox Dosage for Masseter Muscle

Botulinum toxin injection into the masseter muscle is an increasingly popular off-label procedure. It has been used in the management of bruxism, temporomandibular joint disorders, and hypertrophic masseteric pain. Aesthetically, it is used for facial contouring and jawline slimming.^{7, 8}

The recommended Botox dosage for the masseter muscle is 20-30 units per side. 

Treatment is administered into two injection sites per masseter, for a total of four injection points bilaterally. The overall dose is 40–60 units when both sides are treated.

The injection should be performed intramuscularly into the lower one-third of the masseter muscle. Palpation of the muscle during clenching accurately localizes the hypertrophic area.

Dilution Instructions for Botox Dosage

Proper reconstitution of Botox is essential to ensure accurate dosing. 

To prepare the solution, reconstitute a 50-unit vial with 1.25 mL of diluent or a 100-unit vial with 2.5 mL of diluent. You will get a concentration of 4 units per 0.1 mL, which aligns with standard dosing protocols.⁹

When reconstituting, slowly inject the diluent into the vial so the solution does not foam. Confirm that the vial vacuum draws the diluent inside, and if it fails, discard the vial. Mix the solution gently by rotating the vial; do not shake vigorously to prevent damage to the toxin.

Use the reconstituted solution within 24 hours. Keep it refrigerated at 2-8°C until administration, and discard any remaining solution after that period.

Draw the required volume with a sterile, calibrated syringe such as a tuberculin syringe for precise measurement of small volumes. 

Expel air bubbles before switching to a 30-33-gauge needle, which reduces patient discomfort and provides greater control for intramuscular injections. Always check needle patency before beginning the procedure.

Innotox vs Botox Dosage Differences

Innotox (MedyTox, South Korea) and Botox Cosmetic (Allergan/AbbVie, USA) both contain botulinum toxin type A.

However, there are certain Innotox vs Botox dosage differences we need to be aware of. 

Innotox is a ready-to-use, sterile liquid formulation produced by Medytox using proprietary Lyo-liquid™ technology. By contrast, Botox supplies come as a vacuum-dried (lyophilized) powder that you reconstitute with preservative-free saline immediately prior to use. 

Also, Innotox comes in 50-unit and 100-unit pre-filled vials, while Botox is available in 50-unit, 75-unit, 100-unit, and 200-unit vials. 

Both products share the same 150 kDa neurotoxin core, but differences in complexing proteins, stabilizers, and formulation affect their dosing. 

Maximum Safe Cumulative Dose for Botox

According to the FDA-approved prescribing information, the maximum cumulative Botox recommended dose in adults is 400 units within a three-month interval, regardless of indication.¹⁰

In clinical practice, recommended doses in cosmetic applications ensure that the total injected volume remains below the 400-unit threshold. 

For example, combining full upper-face treatment (glabellar, forehead, and crow’s feet; approximately 64 units) with platysmal band reduction (up to 36 units) and masseter contouring (40-60 units per side) can bring cumulative doses near 200-220 units in a single session.

Source Authentic Botox From Doctor Medica Today

Good Botox outcomes also depend on the authenticity of the product you use. Counterfeit or improperly handled botulinum toxin formulations can compromise both patient safety and treatment results.

Therefore, you should procure Botox exclusively from registered, reputable distributors who guarantee product authenticity. 

Doctor Medica is a trusted medical supplier that provides licensed practitioners with genuine, FDA-approved Botox and other medical injectables at competitive prices.

Contact us today to source your next batch of the world’s favorite cosmetic treatment. 

FAQs

What Dosage Forms Is Botox Available In?

Botox is available as a lyophilized powder in single-use vials containing 50 units, 100 units, or 200 units of onabotulinumtoxinA.

What Botox Dosage Is Appropriate for Children?

For pediatric patients (≥2 years), Botox is used only for therapeutic purposes. In lower limb spasticity, the recommended dosage is 4-8 units/kg, divided among affected muscles. It should not exceed 8 units/kg or 300 units per session.

Does Zinc Help Botox Last Longer?

Some studies suggest that zinc supplementation with phytase improves botulinum toxin efficacy and prolongs duration by supporting enzymatic activity. 

How Much Does a Unit of Botox Cover?

One unit of Botox represents a standardized measure of biological activity, not a fixed treatment area. However, on average, we can estimate that 1 unit of Botox treats about 1-2 square centimeters of muscle area. 

References

1. American Society of Plastic Surgeons. PLASTIC SURGERY STATISTICS REPORT 2020.; 2020. https://www.plasticsurgery.org/documents/News/Statistics/2020/plastic-surgery-statistics-full-report-2020.pdf

2. The Look of 3^SM | BOTOX® Cosmetic (onabotulinumtoxinA). BOTOX® Cosmetic HCP. Published 2022. Accessed August 24, 2025. https://www.botoxcosmetichcp.com/thelookof3

3. Biello A, Oney R, Zhu B. Botulinum Toxin Treatment Of The Upper Face. PubMed. Published 2022. https://www.ncbi.nlm.nih.gov/books/NBK574523/

4. Kaufman-Janette J, Cox SE, Dayan S, Joseph J. Botulinum Toxin Type A for Glabellar Frown Lines: What Impact of Higher Doses on Outcomes? Toxins. 2021;13(7):494. doi:https://doi.org/10.3390/toxins13070494

5. HIGHLIGHTS of PRESCRIBING INFORMATION. BOTOX Cosmetic (OnabotulinumtoxinA) for Injection, for Intramuscular Use Initial U.S. Approval: 1989. RECENT MAJOR CHANGES. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/103000s5306lbl.pdf

6. Angelo-Khattar M. A Novel OnabotulinumtoxinA Treatment Technique to Obtain Predictable Outcomes in Eyebrow Position and Shape. Clinical, Cosmetic and Investigational Dermatology. 2020;Volume 13:781-787. doi:https://doi.org/10.2147/ccid.s275841

7. Kundu N, Kothari R, Shah N, et al. Efficacy of botulinum toxin in masseter muscle hypertrophy for lower face contouring. Journal of Cosmetic Dermatology. Published online February 28, 2022. doi:https://doi.org/10.1111/jocd.14858

8. Sipahi Calis A, Colakoglu Z, Gunbay S. The use of botulinum toxin-a in the treatment of muscular temporomandibular joint disorders. Journal of Stomatology, Oral and Maxillofacial Surgery. 2019;120(4):322-325. doi:https://doi.org/10.1016/j.jormas.2019.02.015

9. BOTOX® Cosmetic (OnabotulinumtoxinA) Important Information a QUICK GUIDE to BOTOX ® COSMETIC RECONSTITUTION BOTOX COSMETIC OnabotulinumtoxinA Injection. https://www.botoxcosmetichcp.com/content/dam/botox-cosmetic-hcp/documents/BTXC%20How-To%20Reconstitute%20Guide.pdf10. Chiu SY, Patel B, Burns MR, et al. High-dose Botulinum Toxin Therapy: Safety, Benefit, and Endurance of Efficacy. Tremor and Other Hyperkinetic Movements (New York, NY). 2020;10. doi:https://doi.org/10.7916/tohm.v0.749