Botox not working.

Hi, I'm in my 20's and tried Botox for the first time 2 years ago as I frown a lot and i get a lot of pressure/stress accumulate there. I started with a small dose that barely lasted 2 weeks. I tried again a year later with a different doctor that gave me a heavy dose and by 3 weeks it was practically gone! The effect when it does work is amazing as it really relaxes me. What can I do? Is there another product I can use? Thanks!

Doctor Answers 9

Duration of Botox is dose dependant

Thank you for your question. You may not have enough Botox injected; typically the glabella area requires 20-30 units. If you still do not have success, you can try either Dysport or Xeomin. Please always see an expert injector. Best of Luck!

Summit Emergency Medicine Physician
5.0 out of 5 stars 45 reviews


Good Afternoon and thank you for your question.  I am sorry to hear that you are not achieving the desired results from your Botox® treatment.  It’s important that you go to a board certified injector that has the knowledge and experience with injectable treatments.  Typically, in the frown line area the dosage is 20-30 units.  There are two other FDA approved products that you can consider which are Xeomin® and Dysport® however they typically produce the same result.  The key would be finding the correct number of units, which is unique to each individual patient. An experienced injector would be able to evaluate you first and then determine the correct amount of units you would need. Best of luck to you!

Leonel Calderon, MD
Miami Physician
5.0 out of 5 stars 2 reviews

Three different botulinum toxin products available

There are three different products available in the US: Botox, Xeomin, and Dysport. Occasionally, there are patients who do not have a satisfactory result with Botox. When this happens, the dosage of Botox can be adjusted. Alternatively, you can also have one of the other products injected. Don't give up hope yet! Try following up with your original doctor or find a new one who has significant experience with injecting Botox.

Henry Lee, MD
Warren Oculoplastic Surgeon
5.0 out of 5 stars 1 review

Duration of Botox is dose dependant

It seems like you are not getting enough Botox. It should be 20-30 units at least in the glabellar area. If still no success, you can try Xeomin but I don't think this is necessary. Make sure you get a board certified physician to do this.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Botox not working

Botox should have worked and there is no reason to change to Dysport or Xeomin because they are basically the same. I would be sure to see a board certified dermatologist or plastic surgeon who is experienced and go from there

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 4 reviews

Botox not working.

There are several neurotoxin preparations available to temporarily relax muscles and thereby decrease frown lines. They generally last about 4-5 months when injected properly and at the correct dose.  They are: Botox, Zeomin, and Dysport.  You just need to find the right board certified plastic surgeon who uses the proper technique and then stick with that person. Best wishes.

Janet Woodyard, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 16 reviews

Botox not working

Thank you for your questions, and I'm sorry you are not getting the results you are after. Botox and Dysport will typically begin to "kick in" after 4-7 days, but some may see results earlier. The full effect is usually seen after 7-10 days so two weeks after your injections is a great time for a follow-up with your injector if you are not getting the results you desire. Additional injections may be given at 2 weeks if more correction is desired/needed. Botox/Dysport typically last 3months, and after that it begins to slowly wear off. Be sure to see a Board Certified injector for the best results.Benjamin J. Cousins MD

Benjamin J. Cousins, MD
Miami Beach Plastic Surgeon
5.0 out of 5 stars 10 reviews

Botox not working

You may have very strong muscles and would need a higher dosage. Occasionally I will use Dysport or Xeomin in people who don't respond or stop responding to regular Botox.

Byron A. Long, MD
Marietta Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Botox not lasting long

Some people require a higher dose of Botox than others, so it is possible that you just need a larger dose to give you a longer lasting effect.  It would be important to know what doses you were treated with previously.  Trying Dysport instead of Botox would be another option, but generally speaking, they give similar results.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.