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Botox Stopped Working: Resistance?

I've had Botox for frown lines, crows feet, and forehead wrinkles about 6 - 8 times since 2004. I travel a lot so have been to several different doctors and always had wonderful and almost immediate results. In January this year, I went to a new doctor and was disappointed with the results - I felt the treatment was too conservative - did not get as dramatic or long lasting result. In October, I went to someone else, absolutely no results; 2 weeks later they did more Botox - still no results. Then about a week ago, after consulting with the Botox rep, they tried to inject other facial muscles - still no results. I have been reading about Botox resistance, and it seems patients with resistance experience this from the very first injections. But mine is years after the fact. What does this mean? What can I do short of surgery?

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7 Doctor Answers | Asked by DoeS in Michigan

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Botox resistance for hyperhidrosis treatment

I have seen a dozen patients who have developed resistance to Botox after injection with Botox in the underarms. This is very unusual but can be explained by the fact that the patient has developed resistance to it. These injections were done by several doctors before they came to see me, a hyperhidrosis specialist, and therefore it gives support to the fact that "the injector" was not a factor but the recipient patient was. These patients had at least 3 injection sessions... more

Resistance not always immediate

Resistance to Botox is not as well understood as we would like, but it is most likely to be related to formation of antibodies (an immune system response). This does not typically occur early on, but after several injection sessions. There is some evidence that having injections too frequently, less than 3 months apart, may make it worse! There are some more invasive options such as the "no-tox" procedure or browlift. Your best bet might be to wait at least 6 months and try it... more

Botox resistance is possible

It is possible to become Botox resistant. In fact for the two patients we have had in our practice over the past 5 years that have experienced this phenomenon, it has happened after they have been using Botox for a period of years. There is no easy explanation for why this happens, but the product simply does not have the same effect after it does. With both cases, our experience was the same as Dr. Baxter's that the patients were getting injected more frequently than recommended (and... more

Harold J. Kaplan, MD

4 reviews

Los Angeles Facial Plastic Surgeon

www.celibre.com

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Botox Resistance

Botox resistance has been reported, and it sounds like you are maybe one of these individuals. Botox is botulinum A toxin, a product available in Europe and soon to be available in the US is Reloxin which is Botulinum toxin B. This should work for you.

Steven Wallach, MD

13 reviews

Manhattan Plastic Surgeon

You are probably developing resistance

since you have seen and been treated by several different drs and are not having any result regardless of who is injecting you, strongly suggests that you are developing resistance. this is uncommon but certainly can happen. It usually happens after multiple injections. i have had this in a few pts and for unclear reasons, in some cases, when i re-injected them a few years later, they responded. david berman md board certified plastic surgeon northern va

Resistance is Futile

Botox is a purified protein produced by a bacterium, which causes blockage of the release of neurotransmitter from nerve endings to muscles. The immune system may react to this foreign protein by forming antibodies to it, in an effort to neutralize it. This may be compared in some respects to what is seen in snake-handlers, who may develop a partial or complete immunity to snake venom because of repeated exposure. It is possible to develop a partial immunity to Botox, or also possible that... more

Filler versus paralytic

It's certainly possible that antibody formation has occurred, in which case Botox will be unlikely to paralyze or weaken the muscles of facial expression. (And don't get your hopes up for Reloxin, since it's also botulinum toxin type A and should be antigenically the same). Myobloc--botulinum toxin type B--may be worth a test, but it's generally reserved for non-cosmetic use for disorders of muscle spasticity. Bioform's technology for electrically frying the nerve branches to these muscles... more

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