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I Do Not Have Lasting Botox Results. What Are my Alternatives?

asked 1 year ago by Notperfect in Chicago, IL.
Latest answer by Sanusi Umar, MD
Question viewed 821 times
Tags: forehead, alternative, long-lasting, results

I do not seem to have lasting effects from Botox-type injections. I do see an improvement but it typically lasts no more than a month or two, and by month three its effect has completely worn off. My problem area is the forehead, and my doctor has tried increased dosages, different brand (Dysport). Nothing. He feels that a forehead lift is not indicated (I'm in my 40s and my skin is not lax). Are there any options for me? Thank you.

17 answers to I Do Not Have Lasting Botox Results. What Are my Alternatives?

Botox in Forehead is Not Working.

Hi NP. Two variables would be the number of units being used and the technique. We might suggest seeking out another injector to find out if another MD would be able to affect a different result. We see very few patients that metabolize Botox this quickly so it's worth trying another injector before considering surgery. Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

www.celibre.com

Botox Alternatives For Short Lasting Results

It is difficult to determine the reason you are not seeing results with either Botox or Dysport. Some people do metabolize Botox fairly quickly. However, the technique, the number of units administered as well as the concentration of the injection solution may have played a part in the outcome you described. As another consideration, some patients have experienced successful natural looking results with Radiesse used to correct forehead wrinkles. Radiesse does not target the... more

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon

If you don’t have lasting results, it may be because you’re not getting enough product

If you don’t have lasting results, it may be because you’re not getting enough product. Or, it may be because you have a resistance to the product (but that’s pretty rare). Xeomin, the newest neuromodulator, may be more effective in some patients who don’t respond well to BOTOX, but it may also be the injection technique and the amount of product being injected. And, some patients just respond less well to BOTOX overtime. Your options are changing the dose,... more

Joseph A. Eviatar, MD
Bronx Oculoplastic Surgeon

Botox alternatives.

The advice you have seen here appears to all be very sound advice. Without seeing a picture and knowing how many units have been used it is hard to be more specific. However, it is possible to have the muscles causing your glabellar frown lines to be weakened surgically without doing a brow-lift. You might discuss this with your plastic surgeon. Once the muscles have been weakened by partial removal your Botox will last much longer as the dose to muscle ratio will have been substantially... more

Paul Vitenas, Jr., MD
Houston Plastic Surgeon

Botox Results

I think you have received some great advice here : check the dosage delivered by your doctor, make sure it is authentic Botox from the US company Allergan, etc. There has been one recent development regarding Botox. Although studying "blepharospasm" patients recieving Botox, there may be a clinical correlation to ingesting oral Zinc prior to your injection which may enhance the results. Has not been sufficiently studied, but might be something out there on this...stay tune more

John Philip Connors III, MD
Atlanta Plastic Surgeon

Neurotoxin not lasting long

In a litle while there will be a topical agent available that is also a neurotoxin. This is not to be used on the forehead alone, but in conjuction with injected neurotoxin- you may see longer results.

Purvisha Patel, MD
Germantown Dermatologist

Botox not working long enough

It would be helpful to know how many units were injected. Unfortunately, patients tend to metabolize Botox at different rates, so Botox may not last as long in some individuals. That being said, with continued treatments with Botox or Dysport, the muscles may weaken and require fewer injections over time.

Ryan Greene, MD, PhD
Fort Lauderdale Facial Plastic Surgeon

Botox resistance may be a factor in inadequate treatment result

As you have been through multiple different approaches to your Botox injections (dosage changes, different formulations) with no improvement in the outcome, it is likely that your response is as good as it is going to get. While the vast majority of patients get better and more sustained responses, there are some who get a Botox result like yours. A few patients have some degree of Botox 'resistance' and just can't get that more significant and sustained result. While I think... more

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon

Alternatives to Botox for glabellar frown lines in Botox non-responder.

There are other forms of Botulinum toxin pending release by the FDA but not currently available. One example is Puretox by Mentor (now J&J). For isolated treatment of the frown lines a radiofrequency abalation to fhe branches of the nerve to the corrugators can provide long term treatment but are most costly. This is called GFX. Another option is endoscopic or trans-blepharoplasty resection of the corrugator muscles

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Change Dilution

It seems if the Botox is diluted less, then it may last longer. ( Not to go through the whole dilution thing again, this has been addressed before: muscle relaxation depends on units given and not CC's). In other words if your physician dilutes your Botox with 1 cc of saline the effect seems to last longer than if it is diluted with 2.5 cc, the standard Allergan recommendation.). Also, your physician might inject more into the depressors ( the glabellar muscles), this causes an... more

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Botox or Dysport not lasting enough

If it is your upper forehead that is being treated, then possibly not much more can be done without a lift because more units may help increase the duration of effect but it may drop the forehead too much and over the age of 40, looser or sagging upper eyelid skin can become more of an issue as the forehead can't actively contract and help lift the upper eyelids. If it is the glabella between the eyebrows, then possibly more units may help but you would have to be... more

Ronald Shelton, MD
Manhattan Dermatologist

Botox - how long does it last

I'd be curious to know how much Botox was used and also see a picture. If you have deep forehead wrinkles - you may need a forehead lift. For some people with deep wrinkles who are using their forehead muscles to raise their droopy eyebrows - Botox can actually make their eyebrows more droopy and make their eyes look even older. Therefore, Botox is not for everyone - a careful analysis of every patient's anatomy is critical to decide what can and cannot be done with... more

Catherine Huang-Begovic, MD
Beverly Hills Facial Plastic Surgeon

What to do if Botox doesn't last?

How long Botox lasts in a person depends on a few factors: 1. How many units are used. More units will lead to longer lasting results, however, there is a trade-off. More units may mean your face will not look natural, but instead frozen. The latest trends in cosmetic procedures are steering far away from the frozen look to a more natural, relaxed but still able to make some facial expressions, look. 2. Botox wears off quicker in people that do a lot of exercise, as do... more

Emily Altman, MD
Short Hills Dermatologic Surgeon

Botox Alternatives

Botox has had the US market cornered until recently. If you are experiencing incomplete blockage, or good results that last only a month or two, you might want to consider trying Dysport. It is the only other FDA approved neuromediator approved for wrinkle reduction in the US. While individual results vary, I have had a number of patients who respond better to Dysport v. Botox, and vise versa. Another option is surgery. The results you see with Botox or Dysport, can usually also be... more

Joseph Mele, MD
Walnut Creek Plastic Surgeon

Botox wearing off too quickly?

Some people do require more units of Botox for lasting treatments (or Dysport). You say you've had increasing amounts used, but you didn't indicate how many units were maximally used. That information would be helpful in answering your question. If surgery isn't the right option for you, I would continue to use Botox or Dysport. You'll find over time that you need to use less and less of it, and that you can space your treatments further apart and... more

Carmen Kavali, MD
Atlanta Plastic Surgeon

Over time botox may last longer

If surgery has been ruled out, you may take some consolation in the knowledge that with continued use of the botox, the muscles causing the wrinkles may eventually weaken and finally need less or less frequent injections.

Christopher J. Peers, MD
South Bend Facial Plastic Surgeon

www.peerscosmetic.com

Alternatives to botox

If you have very strong muscle and Botox does not seem to work, then perhaps you may want to consider a consultation for potential surgical procedures to accomplish your goals?