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

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.

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.

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.

One thing is clear, there are a whole lot of goofy BOTOX treatments out there and a whole lot of goofy BOTOX injectors out there.  WIthout before and after photos which I don't suppose you have, it is very difficult to precisely know what is going on.  Our memory plays tricks on us.  BOTOX is maximal at 3 weeks in its effect.  It may be that you associate complete paralysis with BOTOX effectiveness.  Any movement and you think the BOTOX has worn off.  This is far from the truth.  Actually complete paralysis is not a desirable treatment end point.  Instead we want to alter muscle balance.  It is this type of effect that lasts 4 to 6 month.  Google my microdroplet BOTOX method to learn an alternative method of injecting BOTOX.  Please stop having the rep inject you!

You may have very strong facial muscles and a metabolize the Botox product quickly. You may want to try another neuroparalytic, such as Dysport, or even GFX (No Tox). Best of luck! 

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.

 

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.

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 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.  

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.