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.

Baberham,

Good question.  there are many factors that can lead to botox therapeutic failure.  As you probably already know, it may take up to a week to see the effects of botox.  It is wise to keep close record of the number of units required to treat a given area.  If too few units are used, you will see a lesser effect.  3-5% of chronic Botox users develop antibodies that inactivate the toxin.  This is rare.  The potency of Botox diminishes with time after it is reconstituted.  It arrives at your doctor's office freeze-dried and is then mixed with saline.  One study showed a 50% decrease in the potency over a 7 day period.  Thus, the longer it is stored, the less effective it may be.  Botox is a fragile substance.  It is recommended to avoid agitating the vial after mixture and to avoid contact with the toxin and alcohol.  It is easily denatured and should be handled with care by your practitioner.  If you have had great results with one provider, I would stick with him/her.

Good luck

Effectiveness of Botox depends on the source (Allergan in Us vs other source), concentration of the product and the doctor's level of expertise and ability to effectively deliver the dose to the correct muscle to bring about the goal. These aspects are controlled by the physician....shipping conditions, manufacturing conditions, expiration, etc. are controlled by the manufacturer. 

We inject a significant amount of Botox in our office and have occasionally noticed variable effectiveness of the equivalent doses of the drug in certain patients that previously responded well. Have your physician report the lot number to the manufacturer. Review the dose with your doctor as well....Multiple sources of decreased effectiveness, but I would start with your doctor and review the results with him or her.

Dr. C

johnconnorsmd.com

These issues should be examined to see why your Botox didn't work.  1) Was it real "Botox", purchased in the U.S. from Allergan,  2) had it expired,  3)  was it diluted correctly so you recieved enough units and injected correctly.  There is also a rare patient who does not respond to Botox.  Best to return to your injector and discuss how best to correct the problem.