I'm a 47-yer.old Man with Strong Forehead Muscles. I Did Botox Twice, but See Very Little Improvement.. Any Suggestions?

The first time Botox didn't work at all, the second time horizontal wrinkles got softer, but still there, the same as between the eyes. Doctor is using an Allergen Botox Cosmetic. Each time he gave me 100 units. He is saying that my muscles are too strong and I need more injections then 2 sessions. Is this true? or I just have resistance to Botox?

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6 Doctor Answers | Asked by frankcowper

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Performance of Botox for forehead

Resistance to Botox occurs in 1-3% of patients. This can happen if your body’s immune system is producing antibodies in reaction to Botox’s protein structure. So to reduce the potential for this resistance, the label actually recommends that patients be given the lowest possible dose with longer amounts of time in between treatment sessions. Also you may want to consider Dysport as an alternative to Botox. Dysport is also a botulinum toxin. The protein structure of this... more

Botox and strong forehead muscles

When Botox doesn't "work" we must evaluate the anatomy and determine if the muscles are moving. If the muscles are relaxed and not contracting during active attempt at raising the forehead, then the Botox is working. If the lines however remain, despite the muscles not moving, then more units or more frequent treatment will not help. 100 units is a large amount for a forehead. If the deep lines persist without muscle movement, those lines will start to look better... more

Botox injections and resistance

In most cases, 100 units of Botox, will improve horizontal forehead wrinkles even if you are a male with a strong frontalis muscle. It is possible that if the Botox was not newly reconstituted or improperly stored, that it may have lost some of its potency. It is also possible that you may have some resistance to Botox. If this is the case you could try a higher dosage or try switching to Dysport. Also, check with your physician to determine that the issue is truly a... more

Forehead and botox in men

Men usually have stronger muscles than women, but Botox is usualy quite effective. You can always try Dysport or see another injector.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Forehead Wrinkles Resistant To Botox

It is extremely rare to be resistant to Botox, especially if this was your first or second time trying the product. In this situation, I would make sure the product was not compromised in some way. If the botox was stored incorrectly, for example, it can lose it's effectiveness. It is also hard to advise you without seeing a photo, however, if you have significant laxity of the skin on you forehead, you might see better results with a brow lift than Botox.

Resistance to Botox is very rare

If you really got 100 units, then you may be resistant. 100 units to the forehead and glabella (frown lines between the eyes) should have weakened the muscles considerably. If you were able to frown or wrinkle your forehead 10 days after the injections, then you need more. If the muscles were weak, and you could not frown or raise your eyebrows, the effect was strong enough but the wrinkles may be permanently "ironed" into the skin. The "ironed in" wrinkles can soften if... more