Botox Resistance - why doesn't Botox work for me?

I had Botox injections between the brow. The frown line was still present a few weeks later so I returned for another injection.
I am starting to think that I am crazy. I can feel the other muscles in my forehead "fighting" the paralysis. The line is still there and it seems that from the point of the arch of the brow the muscles are furrowing inward. If I lift my brows the line goes away but when I relax the forehead the furrow is back.
The MD who did my injections said he gave me a lot of Botox. I went to him because he is a friend of one of my friends so I don't think he is using inferior product. But I am so disappointed. Is it possible that Botox just doesn't work for me?

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8 answers to “Botox Resistance - why doesn't Botox...”

A: Why doesn't Botox work for me?

Peter A. Aldea, MD

"Why doesn't Botox work FOR ME?" and "What is wrong WITH ME?" are the most commonly heard self-directed complaints we hear from patients coming to us from other offices or spas thinking that somehow they are to blame for inferior or non-existent Botox results. Let's cover the... more

A: Botox issues

Steven Wallach, MD

It is unusual for a patient to be immune to Botox. However, there are some patients that develop resisitance and newer products not yet available may be helpful( Reloxin).  Reloxin is derived from a different strian of botulinum toxin than Botox.  If the muscle are paralyzed and theline is still... more

A: Botox Resistance if Very Rare, Need for Filler is More Common

David Shafer, MD

Julianna, Resistance to Botox is very rare (1:10,000) and the cause is not completely known. What is known is that your body forms an antibody response to the Botox. If you do have resistance, there are other forms of Botulinum toxin that can be used. That said, it is unlikely that you are resistant. From... more

A: Botox resistance rare, but possible

Brett S. Kotlus MD, MS

It is possible to develop a resistance to Botox, but this is extremely uncommon. Other reasons for failure of treatment can be related to injection technique or inadequate number of units. The dilution technique is not relevant, but the total number of units injected is the key. Another reason for... more

A: Botox Resistance

Kris M. Reddy, MD

There are rare but documented cases of Botox resistance.  If the Botox was stored properly, freshly opened and mixed properly, you may need additional units to obtain optimal results.  You just need to ensure that you are not receiving too many units in order to avoid possible side effects. If a... more

A: Botox "resistance"

Jennifer Walden, MD

Sometimes the muscles between the brows (the corrugators) are bigger and more hyperactive in some people. For this reason, one patient may require a little more of the product than another patient to gain the same amount of paralysis of the muscles. The muscle also spans from the top, or root, of the nose all... more

A: Botox resistance

Stella Desyatnikova, MD

There are occasional cases of true Botox resistance. If you are indeed resistant to Botox (botulinum toxin type A), which is very rare, you might be more susceptible to botulinum toxin type B, which will be coming on the market soon. In these cases, treatment with Restylane can provide enough volume support... more

A: I would agree with Dr. Sinclair's bulleted list...

D.J. Verret, MD

I would agree with Dr. Sinclair's bulleted list completely; however, I do not agree with his assessment that all failures are due to the injector and not the Botox. There are case reports of failure of Botox, even in the cosmetic realm after its reformulation. The most recent of these reports of failure of... more

Comments

Victoria, PA-C
1 post
8 Jan 2009

Hi, I have been getting BOTOX done for the past 7 years every 3-4 months on the regular basis. I am definately resistant to BOTOX. It works for me maybe for about 3 weeks post injection.

m.p.
1 post
22 Jan 2009

I have had botox for many years,eriodically.In the last two months 4 times and you can hardly see the differeince Why? M.M

Michael Sinclair MD
138 posts
1 Jul 2008

Before 1997, there were case reports of patients that developed antibodies to Botox. For those patients, Botox stopped working. In 1997, the formulation of Botox was changed to reduce the chance for antibody formation. I have not heard of even 1 single case since 1997 where Botox antibodies have prevented Botox from working. Botox "failures" are almost certainly due to injection technique, not failure of the Botox. There are complex relationships between the facial muscles. Knowledge of those relationships is necessary to get the desired results from Botox. Furthermore: Botox is not intended to treat all facial problems. Botox does not "work" on static wrinkles (wrinkles that are present even at rest without any motion). Putting too little or too much Botox  can cause failure or side effects. Trying to treat problems that are not appropriate for treatment with Botox can cause "failures". If the Botox is mixed with too much liquid, i.e. too diluted, it may not "work". If the Botox is not kept cold after it is mixed and it is allowed to get warm, it may denature and not work. Creating unrealistic expectations can cause Botox failure. In all of these cases of "failure" the failure was that of the injector, not the Botox. If you are not getting the desired result from your Botox treatments, it is time for you to get a second opinon.

atarial
1 post
11 Mar 2009

this discussion is limited to wrinkles. is anyone experienced with axillary hyperhydrosis? also, feeling guilty that I had insomnia way back a year or two ago when I last had it injected in underarms... might it not had an adequate chance to metabolize as a result? I've read the B strand had like 1:10 cases of "tolerance." But that might be off... I had it fine about 2, 3 weeks into it last time... use to last a solid 4 months first couple of times I had it...

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