Need for Additional Botox Dosage?

I received my second dose of Botox for deep furrows from frowning, a year after my first dose. The dose did not take effect at all seven days later. The doctor stated that I may be a "super user" of the Botox, meaning that my body rejected the dose. He gave me an additional dose and it worked. Was this correct, and would I require more than the normal botox dose in the future?

I have no autoimmune diseases.

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12 Doctor Answers | Asked by nlo in Middletown, De 19709

Doctor Answers (12)
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Botox

Perhaps the Botox used was not enough, or not mixed properly, or old? I could not say for sure, but I am glad it worked out.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Super user of Botox

Rest assurred, people that are actually non-responders to Botox are few and far in between. A "super user" of Botox is a term we are not familiar with. The fact that you responded well on the second treatment would imply that your body is not "eating it up" as it was suggested to you. More than likely, you required a higher, proper dose. Secondly, technique and protocols (ex: dilution, storage, etc) are important in ensuring that you are receiving a quality treatment and... more

Harold J. Kaplan, MD

4 reviews

Los Angeles Facial Plastic Surgeon

www.celibre.com

Some people need more

Some people do require more Botox than others. However, it would be nice to know how many units you were administered at each visit. Also, waiting a year between visits is a bad idea. The Botox wears off after 4 to 6 months. If you wait longer than that for your next treatment, then you are starting over from scratch. In addition to preventing the dynamic wrinkles, the Botox also decreases the stress on your skin and with long-term use will help the static wrinkles from dermal atrophy... more

Don't Believe Your Doc

I hear this all the time. "I went to doctor X, who's famous, and my botox didn't take. I must be a rejector or super user of Botox." Okay, this doesn't happen. What is happening is that these "doctors" are either diluting Botox so much that it's not effective (so that they can make more money on a vial) or they're just not injecting enough. When you went back he realized the issue and injected maybe the correct amount. Most Plastic Surgeons don't make any significant money on Botox... more

Everyone is different

After one year your first dose of Botox was entirely gone. If you have "deep furrows" you must have strong frown muscle action and may well need two syringes of Botox every 4 months or so to lessen them. I once had a male patient who routinely needed 3 syringes in the lines between the eyebrows because his frown function was so powerful.

Botox dosage

Botox can spread differently each time it is used and so its effect and vary each time. In your case it has sound as if it didn't work at all. I have had Botox personally injected into the Glabellar area at various times, and one time it didn't work for me either. It could have been the way it was injected, the material itself, the concentration, etc. However, it continues to work on me in standard doses. It is my opinion, that you will not need additional units but ytou can only... more

Otto Joseph Placik, MD

33 reviews

Chicago Plastic Surgeon

Muscle mass and degree of frowning

I strongly beleive that people have different botox needs based on several factors. The muscle max and the degree of frowning is a major one. I have seen this many times with males who always require a little more than females.

Double dose of Botox

Sometimes it is necessary to touch up a Botox treatment with additional units. Each treatment may be different from the next, as well. So, the same amount of units used for the first treatment might not be fully effective on the second treatment, and the reverse might also be true. At any rate, the amount needed will only fluctuate within a range of a few units.

Some people do need more Botox than others.

Hi! 1) I can usually tell by examining the patient, if someone will need more than usual Botox. One can tell by the size and activity of the muscles. 2) Find out the total number of units you received this time, and it should be consistent each time. 3) For the vertical frown lines between the eyebrows, I typically use 25 units for women and 30 to 40 for men. If you use a little more, I think it lasts longer. 4) Exactly where the Botox is injected is just as important as the number... more

Need for additional Botox

I suspect that an insufficient number of units was injected or the batch of botox had lost its activity after re-constitution. You ought to keep a log of many units you receive in which location(s) for future reference.