Botox. I Am 43 and Had my First Botox Treatement 8 Weeks Ago (50 Units)

The area of my brow worked but crows feet and bunny lines didnt.(well,very slightly) I went back 2 weeks later for top up (40 units) - still no change. Another two weeks on for further top up (30 units) - still no change. This is getting very costly now but I dont want to give up as it will be a waste of what I have paid already. I have read that the technique could be wrong or its has been stored correctly but the nurse is adamant she follows all training guide lines.

Doctor Answers 15

Botox for crow's feet and bunny lines

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It is difficult to comment without seeing your movement but no more than 10 to 15 units of Botox per side is usually needed to relax crow's feet and 2 to 3 units per side for bunny lines.  Please consult a board certified dermatologist or plastic surgeon for assessment and treatment.

Toronto Dermatologist

Nurses and Botox

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The amount of botox used is inappropriate for the crow's feet.  This is an example why it is often more cost effective to have an experienced and expert physician injector perform the treatment. It sounds like either poor technique or improper handling of the botox.

Nurses and Botox

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For what you've paid, you should have a dermatologist or plastic surgeon injecting the Botox.  Injection technique is very important and there is a reason why board certified physicians who have trained in the anatomy of the face have better outcomes than non-physicians.  I am very wary of the medispa approach to patient care.  I agree with other posters than, in that environment, you don't even know if you've been injected with Botox from Allergan Corporation, a grey market product of questionable content, or anything other than saline solution.  I'd definitely see a plastic surgeon and do a little research on the facility at which you had the services performed.

Excessive amounts of BOTOX® Cosmetic do not give greater results.

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BOTOX® Cosmetic is a muscle relaxant and does not diminish the appearance of lines that are visible at rest. It is meant to prevent the further deepening of the lines and, over time, soften the appearance of the lines at rest (due to the diminished muscular contractions in that area). 50 + 40 + 30 is an excessive amount of BOTOX® Cosmetic for the crow’s feet area (the outer eyes).  It is important to understand that if the lines at rest are bothersome and not eliminated with a BOTOX® treatment, there are alternative treatments that can address static lines and wrinkles. You should discuss options with a physician specializing in cosmetic medicine.


Botox not working

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You have been injected with a lot of something, but it is not Botox... or at least it's not active Botox.  It is either something else or it is expired Botox that has been open a long time.  There is no other explanation why you would not have had any response.  Given zero response, I think it's time to ask for your money back and move on to a reputable board certified specialist
Martin Jugenburg, MD

Botox treatment not satisfactory

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I must agree with all of the comments from my colleagues. Time to leave that clinic go to a physician or surgeon for your injections. Botox should be opened and used the same day and should be diluted to a certain standard which may not be the case where you are going . Either way that is a lot of botox to have no result or minimal result. Some wrinkles do not respond to botox and are caused from muscular action in areas that are not treated. As well some patients who do not respond to botox often respond well with Dysport so this may be a possibility as well. If you are trying to treat a condition that is not treatable by botox or dysport then I would suggest not further wasting any money. A good surgeon should advise you in this matter! Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 214 reviews

How Much Botox is Needed for Crow's Feet?

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Hi Melaldo.  120 units of Botox for the crow's feet is way too much.  Everyone on the panel agrees with that.  But in looking at your picture, you are squinting very hard and the muscles in the crow's feet area do appear to be relaxed.  And herein may lie the problem.  

Just because you have Botox at the crow's feet does not mean that all lines will be completely smoothed away.  The wrinkles at the eyelid and below the eye are not appropriate for Botox.  In addition, the lines at the side of the eye may have been too deep to be completely hidden with the use of Botox.

We think that part of the issue may have to do with the expectations set by your practitioner as you may have been expecting something more than was possible.  In any case, too much Botox was used and for that fact alone, we would recommend finding someone else.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Yes the technique may be wrong, but more likely your lines are not suitable for Botox

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Your picture shows a very hard "squint' where the muscles which is being created by muscles which are not treated by botox. The advice given by others that you need to be seen by a physician who can analyze what your needs really are. There are some patients who do not get adequate response to Botox - not due to the product but rather their syle of using the muscles about the eyes. Dr. Mayl Fort Lauderdale

Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon

Botox didn't work

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I am sorry you had an unsatisfactory result from your Botox treatment.  However, I am not a believer in nurses or physician assistants treating patients with Botox (neuromodulators) or fillers.  They usually work in "medispas", and are ill-prepared to deal with complications.  Most patients do very well with Botox, and it has been very rare over the past 20 years for me to see someone with no response (if ever).  I suggest you go to a "core four" (general plastic surgery, facial plastic surgery, oculoplastic surgery, dermatology) PHYSICIAN who has experience with Botox and try again.  Don't give up yet on this wonderful drug.  Yoash Enzer, MD

Yoash R. Enzer, MD, FACS
Providence Oculoplastic Surgeon

Botox didn't work

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 I've used Botox injections to soften lines and wrinkles of the forehead and face for over 20 years and 120 units is quite a large dose.  You need to go elsewhere from now on for your Botox.  The other thing, Botox relaxes muscles to soften lines and wrinkles but it can't remove folds that are a result of excess skin.  If Botox isn't the solution, perhaps another MD or clinic will tell you saving you money, time and effort.

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.