Is there such a thing as a bad, non affective dose of Botox? Its been 10 days & I see no difference in my forehead & crows feet.

Generally botulinum toxin is very effective and it would be unusual for it not to work. However, I have had the experience and it may be attributable to transportation, storage, preparation, dilution or injection technique. Therefore, it is generally worth another attempt. You may want to try Dysport, another preparation of botulinum toxin.

Why might you not see benefit from your Botox treatment 10 days after? Before this question can be answered, it is important to know if the Botox has inhibited the muscle movement. If the eyelid crows feet muscles and the forehead muscles aren't moving then the Botox was effective but the skin creases won't go away "overnight" if they've been caused by years of sundamage and muscle motion. You may see benefit as much as two to four weeks after Botox, and in some cases, patients who have deep lines and maintain their Botox treatment for several sessions (it usually wears off close to four months after treatment) without it wearing off, may see improvement in the lines many months after the muscle stopped creating the wrinkles.

If your muscles are still moving, then it is possible that you need a larger number of units. Some physicians will start low on your first treatment to ensure that you do not get an undesirable result which could take months to resolve. Another reason would be if your muscles are so strong that they need a much higher dose than average. If the Botox were overdiluted (it must be diluted prior to use, and most doctors appropriately dilute with sterile saline in an amount between 1 and 2.5 - 3 ccs) then you may not see a good enough response. Finallly, doctors need to check that the lot of Botox being used has not expired, and that the solution once diluted is not stored for more than a reasonable time.  Experienced doctors  treat so many patients that the bottle lasts less than a week or two, sometimes only one day so there is no concern of shelf life once diluted.

See your doctor in the next week to two for an evaluation of your lack of effect. it may be better by then or you may consider getting a higher number of units.