Can Anyone Tell Me Why 12 Units of Botox in my Frontalis Takes Effect Within 20 Minutes?

Question

I have had botox in my frontalis muscles 3x. Approximately 20 minutes after each time, my frontalis muscles are paralyzed. The prescribing information indicates effect takes 3+ days on average. I am of Basque origin, a population that has a higher than normal rate of pseudocholinesterase deficiency (PD). Could this be the reason even though botox mechanism of action is presynaptic and the literature that I found speaks to PD complications occurring w drugs that act @ the neuromuscular junction?

Ron Shelton, MD · Answer

You have a very interesting question. I asked some scientists and do not have any better understanding as to what would explain your quick action of onset. This would be a wonderful issue for the company, Allergan, to explore.

Harold J. Kaplan, MD · Answer

Hi Sayaah. While we can't say why this is happening for you, it is very unusual. We have never had a patient tell us that they experienced full onset of Botox results within 20 minutes. Normally 1-2 days is typical and we don't do a checkup for first time patients unless at least 2 weeks has passed.

In any case, if you are experiencing very rapid onset, that just means your product lasts longer!

In any case, if you are experiencing very rapid onset, that just means your product lasts longer!

Joseph A. Eviatar, MD, FACS · Answer

BOTOX is variable. Usually it does not respond in 20 minutes. Usually it takes 24-48 hours, but there may also be a placebo effect which can cause it to feel like it works in 20 minutes. That’s not to say that the experience is psychological, but the placebo effect does affect the body without the patient even knowing it.

Darryl J. Blinski, MD · Answer

You are so lucky for rapid onset. My question is longevity of the Botox in you? Maybe have a blood relative have some Botox to see if there is a genetic reason.

Michael L. Schwartz, MD · Answer

Pretty remarkable. some would say not chemically possible. Perhaps the trauma of the injection contributes in your case. No matter, enjoy the instant result.

Can Anyone Tell Me Why 12 Units of Botox in my Frontalis Takes Effect Within 20 Minutes?

Answers (10)