Why did Botox and Xeomin not work on me? (Photo)

You may need more units and perhaps fillers as well to smooth away the lines. You may want to seek the opinion of an experienced injector who is more aggressive.

Based on the photo, you may
need more Botox or it may have been injected improperly. Please
consider seeing a board-certified dermatologist or plastic surgeon.
Also, please keep in mind that Botox injections don't get rid of the
wrinkles right away. Botox relaxes the muscles that cause fine lines
and once these muscles are relaxed, the fine lines improve over months but
they may never fully fade. The way to judge if Botox is working is
if you are still able to move the targeted muscle that was treated.
If you have minimal movement of that muscle, then the injections
worked. Good luck!

Neuromodulators like Botox, Dysport and Xeomin all work. Typically if they don't work, it's related to volume injected not being enough or injection technique. These products need to be injected into the muscle and have about a centimeter diffusion perimeter. If the product is not injected into the right area it will likely "not work". Try another injector and maybe try Dysport.

Thank you for your question.It is very rare that someone will not respond at all to either Botox or Xeomin. Your glabella muscle appears to be very strong which in most cases will require more units of Botox. If the line still appears too deep, filler may be added to soften it as well. To be sure what is best for you, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment.I hope this helps.

Often I am doing 30-50 units in men or people with large glabella.  20-25 units may be too litte.  Also you may want to go to someone who injects this type of 11 line often as I concentrate my botox for these cases (ie dilute the powder much less).  I have never had someone that didnt response, but often even with response filler is needed to complete the line improvement.  I would go to a facial contouring specialist who knows how to treat this with combination therapy.  Best, Dr. Emer.

Considering you have not had a long history of getting Botox treatments, it's unlikely that you have antibodies to the Botox, but it can still be a remote possibility. It is much more likely to be a problem with the injection technique. Many patients can have rather long corrugator muscles, and standard injection techniques can miss the part of the muscle to the sides. I would normally have a first time Botox patient come back after 2 weeks to make sure we got a great result. It's not too unusual to have an occasional patient that we need to "tweek" to get the best result.See someone with extensive experience.Andrew Campbell, M.D.Facial Plastic Surgeon

You could try Dysport for your frown area, but it is possible that it may not work either.  Assuming the injection technique was good, the dose that you are getting sounds reasonable and you should see some effect.  There are a very small number of people who have developed antibodies to Botox (and Dysport and Xeomin) where there is no effect from the treatment.  Antibodies can develop from prior exposure to botulinum toxin, although this is very rare.  

Thank you for posting your question and photo.  Rarely someone can develop antibodies to the neuro-modulators but this is usually after many treatments.  Since you had little to no results after a few injections,  it is more likely the lack of effect is due to poor technique.  If you wish to see about  Botox/Xeomin, contact a board certified plastic surgeon and have her/him do the treatment.  Best wishes.

In rare instances, people can be resistant to the effects of Botox/Xeomin/Dysport, likely due to development of antibodies.  Xeomin may have a lower risk of developing antibodies because it consists of pure botulinum toxin, without the accessory proteins that Botox has.  As a side note, I have been using Xeomin quite a bit and results have been excellent.  If neither Botox nor Xeomin are giving you good results, you might consider trying Dysport.  I would also make sure that you are seeing an experienced, reputable injector.  If none of the neurotoxin products work for you, you could try an alternative treatment such as ThermiRase, which targets the nerves responsible for muscle contraction but is more invasive than Botox.