Why Doesnt Botox Last More Than 2 Months on Me? I Have Had It on Four Occasions with a Rep Injecting Very High Doses Same Result

I have had botox on my forehead and in between eyes and on each occasion the botox has worn off in less than 2 months,The botox company rep cam out twice and injected high doses herself to resolve the issue free of charge however the results are the same.She recommended I just get botox once a year for special occasions but otherwise its not for me. I dont understand why? I am 37 with relatively great olive skin, just wanted to start working on my forehead.

Doctor Answers 14

Botox without results?

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Unfortunately, you haven't indicated the dosage or shown us the condition. If Botox is properly injected, it should not create a frozen face but, rather, the musculature should be mobile---but in the positive direction only! I don't you what your expectation level but would suggest that the only persons who should be injecting you would be board certified dermatologists and plastic surgeons. Cosmeticians, nurses and drug reps may not have the same technique and understanding of the facial musculature.

Botox results for your forehead and frown lines

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It is possible you have become resistant to Botox and could try another neurotoxin.  You might also consider another physician injector whose technique may be different and work better for you.


Martie Gidon, MD, FRCPC
Toronto Dermatologist

How many units of botox is considered high?

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Interestingly in the United States we don't have reps inject anything! Your shorter than desired longevity of the Botox duration may be your norm.  It can last up to four months but in some patients only three and a few I've seen only six weeks.  Your metabolism of the product is different than the next person.  possibly your doctor and the rep used high units but in reality they weren't high. Some women need more than 25 units for just the glabella (in between the eyebrows). Some men whose muscles are generally, but not always, more bulky and strong int he glabella than women, may even need 35 - 50 units or more. You may just need more but without knowing exactly how many units of Botox you received and wtihout knowing exactly the insertions and depth of injection, it is impossible for me to understand what your situation truly is.

Your doctor might consider a trial of Dysport or Xeomin if available in Australia.  These are similar to Botox but slightly different chemically. Possibly, for reasons we don't understand, unless you're developing antibodies to the Botox, you might get greater duration of effectiveness.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

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How long does Botox last and what factors affect its duration?

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Botox is averaged by the FDA to last “up to” three months. Everyone’s body is different and the strength of your muscles will determine how long Botox will last. The stronger your muscle, the more you will need. In my practice, we always schedule follow-up appointments two weeks after the initial procedure to make sure the product has reached it maximum effect. Then when the patient needs more, we will tailor their injected amount based on how long the product lasted. Unfortunately for most people, it is very hard to determine how much Botox you will need until you have established a good maintenance regimen and this may take up to three visits before getting it right. It is important to understand the factors which influence the length of time the product will last. Again, these factors include: dosage amount and strength of muscles. For some patients, we may recommend maybe trying Dysport as it can last a bit longer in some patients.

Timothy Jochen, MD
Palm Springs Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Why doesn't Botox last for me?

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Hi Romi.  The first question we would have is how many units were injected and which areas?  The amount of product will affect the results.

The second issue is technique.  We have had other patients tell us that they were resistant to Botox and when we dug a little further (asking them about where they were injected for certain areas of the face) we found that the technique was not appropriate for their concerns.

Finally, there are some patients who for one reason or another either do not respond well to Botox.  they may have built up antibodies for it and just metabolize the product more quickly than others.  If you fall into this category, you may want to try another injection product such as Dysport or Xeomin.  Good luck.

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

Botox not lasting as long as expected.

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Botox usually lasts 3-4 months in most patients but numbers such as these are average figures and there is always some patient to patient variability. Another matter is how you define "working". The effect of these products are "worn off" gradually and do not disappear overnight. It is difficult to say what is going on without photographing your face at several treatment points to judge if the product is just starting to lose efficacy or whether it's effect has completely disappeared. I think the suggestion of some of the other panel members to try another neurotoxin such as Dysport or Xeomin are good ones and I would encourage you to try them before giving up. Good luck.

Ted Brezel, MD
Long Island Dermatologic Surgeon

Botox Lasts 2 Months

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We can all speculate, but none of us have the answer to your question. Recent studies suggest that the duration of Botox is not related to the dose administered. You can try the other neurotoxins or simply have the Botox injections more frequently.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Botox not lasting long

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Luckily for you there are other neurotoxins out there if Botox does not seem to be lasting as long. Ask your injecting physician about Dysport and Xeomin.

Some people become resistant to Botox

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Some people will develop antibodies and become resistant to Botox.  I personally became resistant to Botox about 5 years ago.  I switched to Dysport which works great for me.   The New Xeomin is protein free and would be another good choice for you to try.  

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.2 out of 5 stars 18 reviews

Why Doesnt Botox Last More Than 2 Months on Me? I Have Had It on Four Occasions with a Rep Injecting Very High Doses Same Result

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 The effects of Botox like the other neurotoxins Dysport and Xemomin, are dose dependant and do vary between individual patients.  You didn't mention the number of units of Botox injected into the forehead and glabellar areas.  High doses would be 50-75 units of Botox, IMHO.  Another solution may be to have the injections done more frequently until the muscles become weaker and more prone to the effects of a lower dose of Botox.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

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.