Botox not working well after long hiatus from it. Could it be resistance?

Hello little.mermaid.xo! My name is Jessica, I am a physician assistant, and one of the providers at Shah Facial Plastics. There are several reasons as to why the Botox is potentially not as effective. I recommend monitoring for any changes over the next few weeks. If after a few weeks you believe that the Botox is still not as effective and you are still maintaining muscle movement, I recommend trying a different neuromodulator. I hope this helps and best of luck!

You may require a higher dose of Botox to certain areas to attain the same effect as you had three years ago. If even a higher dose isn't working, you may want to try a different neuromodulator such as Dysport.

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Although Botox resistance is possible, I doubt that this is a reason for the lack of effect in the forehead area. The fact that you had a 3 year hiatus and that the Botox was effective in other areas of the face argue against resistance as a potential cause. A more likely explanation would appear to be underdosing in the forehead region.
Best,Dr. Larry Thiesen

It could be resistance which would require higher dosing in resistant areas. Some patients have resistance after Covid infections (this is just a personal observation of mine).
Best wishes,
Dr. Taranow