Hello Interloper!
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So how do you work out the correct dose? It requires a deep understanding of the anatomy and function of the facial anatomy, and an appreciation that everyone is different. So when I see a new patient who is thinking about Botox treatment I will carefully evaluate that persons facial musculature.
I will look at the strength of their musculature by examining their muscle bulk. I will determine the anatomy of their muscles, which is often different from the description in textbooks. I will determine the impact of relaxing those muscles, particularly the frontalis and orbicularis oculi muscles.
In considering the impact I am thinking not only about the aesthetics but also what will happen to the visual function of my patient once their brow is relaxed. They are not going to be best pleased if you paralyze their brow muscles which they are using to keep their heavy upper eyelids elevated and out of the field of their vision
Some areas of Botox treatment are also more difficult to get right than others. In this context, I am thinking particularly about Botox treatment for fine lines around the lips. In this area, one has to be particularly respectful of the power of Botox and tread very cautiously as overdosage can lead to lip incontinence that can last for several months.