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!

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

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.

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