Botox Did Not Work

Hi Jane,
There are several explanations for why your Botox may not be working well for you:

Even though you were injected twice it may be that too little Botox was injected. Normally in the area between the eyes, we inject between 15-25 units.
It is possible that the lines you have are too deep for Botox alone. In cases like these we add dermal fillers such as Restylane to eliminate the lines completely.
It is possible that your injector missed the mark. This is lesslikely as you noted that you are not able to frown.

There are several potential reasons for your result.  One may be that not enough Botox was used.  It may have been placement of the product.   It could be that the lines you had are too deep to be fully resolved from treatment.  Botox works to soften lines that form from muscle activity.  If you had the lines even when you weren't animating, Botox may soften that look but may not be enough to smooth them completely.  I encourage you to visit with your injector to discuss your results and concerns.

Either the Botox was not aggressive enough or you may need fillers to smooth away those wrinkles rather than Botox.  Talk to your injector about this.

Not all wrinkles will disappear with Botox. Let me give you an oversimplified antalogy to explain.
Movement lines and their associated wrinkles are generally caused by the repeated action of the underlying muscles. Weakening the muscles will soften the creasing of the skin and make the wrinkles appear less severe.
This is not dissimilar from the wrinkles which are formed from wearing a pair of pants all day long. When you put them on the hanger at night, most of the wrinkles will soften by the next morning. However, some of the more severe creases will persist. Your face is quite similar.
Botox will put the skin at rest. However it will take several weeks and up to two months to see the full effect on the wrinkles. Most will soften and some will remain.
You may have obtained the maximal benefit and you may want to consider some filling agents to improve any remaining creases once the muscles have fully relaxed.

Dear Jane Smith
First and foremost, it pays to deal with a reputable core physician. This should be some one who is well respected and belongs to one of the core aesthetic specialities: Dermatology, ophthalmology, otolaryngology (facial plastic surgery), and general plastic surgery. Obviously other physicians can and do provide BOTOX. However these specialist have the largest experience with working with this agent. So did you see a core physician? Did you see a physician? Did you pay commodity prices. BOTOX cost the physician in the United States about $5 per unit for just the medication so anyone who sells the product for about $5 USD is essentially giving away the product. Since few businesses can sustain themselves this way, if you are paying a price that seem too good, it probably is too good. It is only the reputation of the physician that ensures that a unit of BOTOX is a unit of BOTOX. I suspect that some providers are injecting their patients with saline. Obviously injecting saline is highly profitable but not very effective. So ask yourself if you went to a factory that is perhaps not on the up and up. This might account for why your BOTOX was not too effective.
If you went to a reputable physician injector, then the suggestion that the BOTOX did not work because it is too old is not valid. Ethical offices do not inject patients with old BOTOX. Once mixed, BOTOX is probably good for two weeks. In my office, it is rare for a vial of BOTOX to last more than a few hours because of the volume of service we do.
I also disagree with the doctor who states that it might take a year to erase a line with BOTOX. If you have a creased skin, then the BOTOX is never getting rid of that line. If that is the case, an ethical core physician will be honest with you before you are even injected to help set your expectations.
My recommendation is do your homework and find an ethical office where you are getting treatment by a core physician. You might look on the liquidfacelift.com website for the name of someone in your area with a large BOTOX practice.