Botox never works for my 11 lines - why? (photos)

Question

40 years old. I tried the best providers and the active frowning won't stop even after the third retouch!! I have been to five or 6 drs I m not talking about the static line I can still frown

Thomas Wright, MD · Answer

Resource,  thank you for sharing your photos. There are some people that are resistant to neurotoxins.
Often one works, but other don't. Have you tried Dysport. Some people that are resistant to the effects of Botox, often respond to Dysport on one the other neurotoxins. I think you should try Dysport and one or two other neurotoxins to see if it is specific or general resistance to their effect.  Wishing you the best of health, Dr

Jason Emer, MD · Answer

"​For glabellar lines (or frown lines / ""11"" lines), we inject Botox, Xeomin, or Dysport into the muscle, causing the muscle to weaken and improving the appearance of the lines. These work by binding to receptors that send nerve signals for muscles to contract. Since your body makes new receptors and neurotransmitters all the time, it needs to be maintained otherwise the wrinkles will slowly return as the muscle regains function over time. Neurotoxins take 2 to 4 weeks to start working and lasts for up to 6 months.

For deeper glabella lines or strong 11s, I use a combination of Botox with fillers, lasers and microneedling with PRP. I suggest getting a formal evaluation with an experienced cosmetic dermatologist and expert in lasers and fillers. Best, Dr. Emer

Nelson Lee Novick, MD · Answer

Barring the use of inappropriate injection technique and/or the use of inadequate concentration of Botox to get the job done, there is a possibility that there is a resistance to the Botox neurotoxin. What's more, if this is so, then repeated injections of Botox would conceivably even make this problem worse, with each succeeding shot acting must like a "booster shot" to increase the resistance to the Botox.  If this is indeed the case, the use of alternative product, such as Xeomin may be worth a try. Additionally, one might consider the addition of a resilient, cohesive, low viscosity filler in the area, which can act as a resistence to the frown line muscles. Hope this helps. Best of luck.

Eric M. Joseph, MD · Answer

Some people respond better to some neurotoxins than others. Have you tried Xeomin, Jeuveau, or Dysport? When it comes to strong corrugator muscles that cause frown lines, the dosage tends to be from 25 - 50 units of Botox. How many units did you receive? Hope this helps! Dr Joseph

Anshul Gambhir, MD · Answer

Thank you for your question! This result could be from botox under dosing. When treating the corrugator muscles which create the 11 lines, it is important to dose based off of your muscle movement. I would recommend dosing between 25-30 units. Another option for the 11 lines could be filler, a product I like to use is Volbella which is made by Juvederm. This is a hyaluronic acid based product used to fill in the area to smooth out the fine lines.

Camille Cash, MD · Answer

Usually if patients are still able to dynamically move the glabellar muscles after treatment it's because they were undertreated or from injector technique.  However based on the information you provided it is unlikely to be either case for you.  You may want to try a different neuromodulator such as Dysport or Xeomin.  If those don't work either you may be one of the few where neuromodulators simply don;t work.

Peter Andolina, DO · Answer

I would recommend you try a different neurotoxin. There are some people that just do not respond well to Botox. It must have something to do with how the medications are processed and made. Luckily there are other products on the market that you can try such as Dysport or Xeomin. It also looks like your glabella muscles are quite strong so you may need a few additional injection points to completely knock the muscle out.

Botox never works for my 11 lines - why? (photos)

Answers (7)

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