Moved to France, went to med spa for Botox. Not happy with result

I have been getting botox for past 5 years at med spa and it always starts to show about 5 days after. I tried to tell nurse the units i usually get. Since this was a new place and i dont speak french i only did crows feet and my 11s. It was the french version of botox made by allergen but it was already mixed. My 11s look ok but crows feet i see no change, she maybe is to conservative or botox was to diluted. should i let her retreat the area and ask to see her make it fresh or ask for my money back?

Doctor Answers 8

Botox Treatments in France

Hello and thank you for your questions, and I hope you get the results you desire. It is best to be treated with a skilled injector like a board certified plastic surgeon or dermatologist who has plenty of experience with neuromodulators. Botox and Dysport will typically begin to "kick in" after 4-7 days, but some may see results earlier. The full effect is usually seen after 7-10 days so around two weeks after your injections is a great time for a follow-up with your injector if you are not getting the results you desire. Additional injections may be given at 2 weeks if more correction is desired/needed. Best of luck.

Benjamin J. Cousins MD
Board Certified Plastic Surgeon


Miami Beach Plastic Surgeon
5.0 out of 5 stars 9 reviews

Botox at Med Spa

Hello, 

I'd recommend booking a follow-up appointment with your injector to discuss your concerns. Ensure that you are seeing a skilled and qualified injector. 

All the best. 

Botox and Med Spa

Hi, and thank you for your question.  As physicians,  and in particular dermatologists and plastic surgeons I  feel that your best option is to have treatment with a core specialty physician rather than a nurse.   Realistically  many patients seek treatment from medspas.      

It seems you have noted a reduced effect around the eyes.  The eye (periocular) response to Botox is less impressive than the scowl, but nonetheless still very acceptable to most patients.  Photographs are always needed as we often don't remember our"before".  Even I had to refer to my pre-treatment photos to remind myself of what the wrinkles looked like before my injection.  Sometimes with low facial volume, the Botox works correctly, softening the lines around the eyes,  but not effecting the lines radiating from the cheeks.  Cheek smilers also can elevate their cheeks and cause temporary lines whilst smiling.  Fillers, not Botox,  are indicated in this scenario.  

As you had an effect in the scowl area, no doubt you had the same effective product injected around your eyes.  You probably require more Botox.  In these cases, I consider it ethical to charge patients by the unit for additional product needed as it has a cost to the physician.  Again, it sounds like your poor response is likely not due to technique around the eyes but simply the need for more product.  

Christopher Dannaker, DO
Monterey Dermatologic Surgeon
4.6 out of 5 stars 5 reviews

You may need adjunctive treatments

A picture with and without a frown would help guidance.

You should wait a week before you consider more Botox.

Perhaps you need adjunctive treatment for static wrinkles using fractional lasers.

Best
Dr. Karamanoukian

Botox issue

First, botox can take a week or so to be completely effective. If it did not achieve the result you want, perhaps you need more?

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Return for a visit

It is a good idea to return for a visit and discuss with your injector.
Hopefully they have someone that can speak English or you can bring a French friend.
You may need more treatment so see what they offer to help.

Botox results

I am sure that there are board certified dermatologists and plastic surgeons in France who are fluent in English.  That you were treated by a nurse with whom you could not communicate effectively is problematic. You can certainly return to inquire but I suggest that you take someone along who is French speaking.

Botox and No results

If you are having no results from Botox then I would definitely suggest that you return to your treating injector for more botox.  I always record a board certified dermatologist for the best results. Best, Dr. Green

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.