What I've learned in 30 years is this: the same 20 units of Botox, when divided into the right points, remains natural; when concentrated in a single point, it always looks "done."
I have been administering Botox for thirty years. In 1996, the standard regimen was still 25 units for the glabella; today, for the vast majority of patients, I administer 8-12 units to the same area, divided into 4-6 points. The total amount of product has decreased by half, but the result is more natural.
This is not just a dosage trend; it's a clinical learning process. 30 years ago, a patient would come in with a "frozen" forehead, and we would call it "effective." Today, a patient comes in complaining of "loss of tone," and we do not accept the same result as contemporary. The difference is not the number of units — it's the distribution map.
I say this in consultations: putting 20 units on your face is not as important as knowing where to place those 20 units correctly. The same 20 units, when given at a single point in the midline of the forehead's frontalis muscle, creates the impression of a "thick band"; when the same amount is divided into 6 points, facial expressions remain fluid, only the lines soften.
This is also why we perform mimic analysis. Each patient's expression lines are different; one raises their eyebrow from the middle, another from the outer edge. If we draw the injection map according to a "standard scheme" instead of the mimic map, the patient leaves the clinic with an expression that "doesn't look like them."
Another observation my 30 years of experience has taught me: completely silencing the forehead frontalis in patients over 50 years old accelerates eyebrow ptosis in the medium term because it removes the support the eyebrow provides against gravity. This is why, in this age group, we don't reduce the dose, but rather the area — we leave the lower half of the frontalis untouched.
Conclusion: we need to stop talking about how many units. What really needs to be discussed is mapping.