Botox Did Not Work

Botox does not always smooth out all lines especially if the lines are very deep or what I call "etched."  They may eventually soften some more with repeated treatment.  Sometimes a small amount of filler may help too.

First, don't go back to where you got Botox. If done correctly Botox should paralyze the muscle within 3-5 days. It can continue this paralysis for several months. For instance I use 25 units in the glabellar region. I just saw a patient back today after 5 months and she's still paralyzed. So anyone who injects Botox and it "doesn't work" after two weeks didn't do you any favors. The next issue is skin memory. If you've frowned for a long time then when you get Botox the... more

Not all wrinkles will disappear with Botox. Let me give you an oversimplified antalogy to explain. Movement lines and their associated wrinkles are generally caused by the repeated action of the underlying muscles. Weakening the muscles will soften the creasing of the skin and make the wrinkles appear less severe. This is not dissimilar from the wrinkles which are formed from wearing a pair of pants all day long. When you put them on the hanger at night, most of the wrinkles will soften... more

Dear Jane Smith First and foremost, it pays to deal with a reputable core physician. This should be some one who is well respected and belongs to one of the core aesthetic specialities: Dermatology, ophthalmology, otolaryngology (facial plastic surgery), and general plastic surgery. Obviously other physicians can and do provide BOTOX. However these specialist have the largest experience with working with this agent. So did you see a core physician? Did you see a physician? Did you... more

Botox works on dynamic wrinkles by paralyzing the underlying muscles and inhibiting the formation of wrinkles in the overlying skin. If you have static wrinkles (wrinkles at rest) then no matter how much Botox you use, the wrinkles are still going to be there. Over time, with constant use of Botox, the dermal atrophy which occurred causing the static wrinkles make improve. In the mean time, you may require a dermal filler to help push out the wrinkles. In general it takes up to two... more

For those people with very deep vertical lines between the eyebrows, it is not unusual that it takes more time to see improvement than when the lines are fine. The lines are there from having contracted the muscles underneath the skin for many years. Botox is not a filler so it does not plump up the line. It treats the cause of your problem which is the muscle movement. If you can not bring the inner eyebrows closer together, then your muscles were correctly treated. Maintain the Botox... more

Jane, As explained by one of my colleagues, it may take several months or even a year of repeated Botox treatments (spaced 3-4 months apart) to completely erase lines that are deeply etched into your skin. If you want more immediacy, the lines can be filled with a hyaluronic acid or collagen based product. Often I will use these treatments in combination to correct the deeply etched, stubborn wrinkle. Good luck!

My best guess is that it is the Botox that was used. My speculation is that the Botox was not "fresh". The drug comes as a powder that needs to be reconstituted with sterile water (I use saline), The manufacturer wants the Botox to be used within four hours of reconstituting because it loses potency. Despit this, many people will use it beyond the 4 hours and some for up to weeks. You may have been injected with "old" Botox. Rarely, people develop a resistance to... more

The effect of Botox is to interrupt the signal from the nerve to the muscle to decrease muscle activity. The reason this helps with wrinkles is because this activity of the muscle "crumples" the overlying skin to produce wrinkles. With time, these "dynamic" wrinkles that occur with muscle contraction become "static" wrinkles that are present at rest. It takes time (several months to a year of decreased muscle activity) for the "static" wrinkles to... more

Thanks for your question. I'm sorry that you've experienced frustration with your Botox procedure. It does sound like you didn't get any effect from the first set of injections, but that the second set did work as intended. In regards to the first set, it isn't known why this lack of effect does occur. Perhaps it is because the Botox became inactive or wasn't injected in the correct area, or even that not enough was used. In regards to the second set of injections that did limit your ability... more

A number of things could havae caused this problem. The Botox could have been old and less potent, the injector may not have gone through the orbicularis ocluli muscle and hit the target depressor muscles, or maybe not enough units were placed for your muscle structure. There is also fairly marked individual variation, in that it takes well in some people and in others ( I hae heard 20%, but this seems way too high.) it does not work at all. I would return to your physician and... more