No Botox Muscle Paralysis After 8 Days. What is the Reason? (photo)

I had my first injection of 20 units between my brows 8 days ago. I have had No reduction in muscle movement! My goal was stopping the furrowed brow look when I'm squinting and to prevent future lines from developing. I contacted the nurse that did the injection she said that botox is exerting its effect for 30 days after injection. The post botox care says results after 2-7 days. Is this normal?

Doctor Answers 11

Botox not working

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Definitely check back in with your doctor. If before pictures were taken, you may see whether or not there is a difference. There is a famous saying - "After a cosmetic treatment, our vision will get better, and our memories get worse!" We often forget what things looked like previously, even though we have a significant change.

If indeed there is no result, there are a number of reasons why. The most likely of these, is that the specialist that injected the Botox either used an improper technique mixing the botox, improper technique injecting the botox, overdiluting, or using the wrong dosage. Botox results vary from person to person. In your case, you will most likely need to return for another treatment before seeing any results. Good luck!

Tampa Facial Plastic Surgeon

No Botox muscle paralysis after 8 days. What is the reason?

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An inadequate amount of Botox or improper technique can be possible reasons you do not see results. Every patient has their own individual circumstances and may require a specific dosage. I would recommend following up with your provider and communicating your concerns to him or her. They should be able to provide you with some advice after an exam. I hope this helps, and I wish you the best of luck.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Reasons for inadequate response to Botox

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Just as every patient is unique, a standard dose may not be sufficient for every patient.  The size and strength of your muscles, in this case your corrugators, will determine the appropriate dosage of Botox.  The dosage and injection technique are most commonly the culprits for inadequate response to Botox.  

Typically full response will be seen in 7 days, though rarely some change may be observed up to 14 days.    

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 64 reviews

Botox not working?

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I would wait another week and then go back to see the person who treated you. Either the Botox was too old or not enough was used. If they can't fix the problem then find someone else to try next time. 

Carey Nease, MD
Chattanooga Facial Plastic Surgeon
4.1 out of 5 stars 24 reviews

No result after botox

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Typically noticeable results are evident by 2-7 days.  Though it is possible you may still get some more improvement, it is unlikely this far out.

There are several reasons for poor response including problems with the batch of botox used, injection technique, amount used.

I'd recommend following up with the injector to show him/her the results you have and ask what next.

Daniel Berg, MD
Seattle Dermatologic Surgeon

No Botox Muscle Paralysis After 8 Days. What is the Reason?

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YES! If you do not see any result after 7 days than you have an issue. 1. out of date BOTOX, 2. Improper injection/injector method, 3. Not enough units given or over diluted BOTOX. Seek ONLY MD injectors. 

Botox an results

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Usually Botox takes about a week to kick in.  Some patients have stronger muscles than others and may need more treatment.  I tell patients to give it two weeks and come in for a follow-up.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Frown lines persist

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After a week you should see some effect from the Botox.  Possible reasons for an incomplete effect would be insufficient dose, incorrect placement of the injections, an unusually strong set of frown muscles requiring more Botox, or a batch of Botox that was shaken, heated or stored in suboptimal conditions. By now if you can still frown, you should return to your injector for a touch up.  Good luck!  

Marilyn Pelias, MD
New Orleans General Surgeon

Botox and onset

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Eight days is an adequate time for botox to start working, but I always give it two weeks before assessing full effect. Thirty days is ridiculous. After two weeks, if you still remain dissatisfied, return to your injector. Some people have very strong muscles that need higher doses of botox to get relaxation.


Ramona Behshad, MD
Saint Louis Dermatologic Surgeon

Botox Takes Up to 2 Weeks to Take Effect

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Dear DanielleG78,

Botox is a very effective treatment for reducing wrinkles and frown lines.

Botox typically begins to work within 2-7 days, but full effect may take up to 2 weeks.

If you do not see any results after 2 weeks, consider followingup with your injector. Additional treatment may be needed.

As an aside, please choose a highly experienced and knowledgeable practioner (eg. Board Certified Plastic Surgeon, Facial Plastic Surgeon, or Cosmetic Dermatologist).

Warmest wishes,

Larry Fan, MD



Larry Fan, MD
San Francisco Plastic Surgeon

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.