Why is my Botox not lasting?

Question

Every time I get Botox injection it's not lasting longer than 6-7 weeks. I get about 50 units altogether in my crow's feet , forehead and bunny lines. I personally think it's too diluted..

Zoran Potparic, MD · Answer

It is well known fact that there is a small group of patients who have very short duration of result after Botox injection. Replacement with another neuromuscular modulator and change of the injector should be your next steps. Hope this helps.

John L. Burns Jr., MD · Answer

Hi! Several factors could be influencing the longevity of your Botox injections.

Dilution of Botox: While it's possible that the Botox solution is being diluted more than usual, reputable practitioners typically follow standardized protocols to ensure efficacy. The dilution ratio, however, can vary between practitioners, but the overall amount of active ingredient should be consistent. It would be worthwhile to discuss this with your injector to understand their specific practices.

Individual Variability: People metabolize Botox at different rates. Factors like your muscle mass, metabolic rate, and lifestyle can influence how long Botox lasts. For instance, very active individuals with a higher metabolic rate may break down the product faster.

Frequency and Consistency of Treatments: If you are new to Botox, it may take a few treatment cycles for your muscles to become adequately trained to relax, which can lead to longer-lasting results over time. Consistent treatments at regular intervals might help in achieving more prolonged effects.

Dosage: The total of 50 units you mentioned for crow’s feet, forehead, and bunny lines is a common dosage, but it might be on the lower end for some individuals. Increasing the dosage slightly under professional guidance can sometimes yield longer-lasting results.

Technique: The injection technique and precise placement of Botox can significantly impact how well and how long it works. Ensure that your practitioner is experienced and skilled in administering Botox.

Product Quality: Verify that your practitioner uses authentic Botox from a reliable source. Counterfeit or expired products can be less effective.

Jason Emer, MD · Answer

The results of Botox lasts up to 3-4 months hence you will have to re-inject roughly 3x per year. When administered by an expert injector you shouldn't have an issue with too much laxity. Results can be softened with Venus Legacy and Thermage treatments. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. EmerThe biggest issue will be muscle weakness if you inject too large doses, which will be required in larger muscles (as compared to cosmetic forehead/face injections) See an expert. Best, Dr. Emer.

Eric M. Joseph, MD · Answer

In our experience of 25 years, to correct somebody's forehead, crow's feet, and Bunny lines could require up to 87.5 units of Botox. It sounds like you are not receiving enough and it is getting spread over too many areas. Thank you for your question and I hope this is helpful. Sincerely, Dr Joseph

Joseph Mlakar, MD · Answer

Hello ! It could be how the office where you are getting the treatments done at are diluting the product or it could be that the amount of units need to be increased. There are so many variables that play a role, it is best to have an open conversation with the office whom is doing your injections

Nelson Castillo, MD · Answer

Thank you for sharing your question.  There could be a number of reasons for the duration of your results - inadequate dosing, poor product dilution, inherent metabolism, etc - and I would recommend either increasing your dosing or switching to a different neuromodulator to see if you have improved results.

Rick Ramos, MD · Answer

Hi! Sometimes people have a better reaction to Dysport and prefer this over Botox. You can try using this next time and or seeing a different provider for your treatments.

Camille Cash, MD · Answer

Botox longevity varies by person, area injected, and number of units used.  Typically the product lasts three to four months.  If you are noticing that you still have muscle movement of the treated area two weeks after injection you may be undertreated.  If you are concerned that your injector is diluting the product I encourage you to visit with another experienced injector near you.

Supriya Tomar, MD · Answer

There are a few possible reasons botox doesn't last as long, and diluting it too much is possible but not always the case. You may not have received enough, or it's possible that your body is metabolizing it more quickly than before, or you may need to try a new brand. Some patients do well with some brands of botox and not others. Try switching to another brand (Botox, Dysport, Daxxify, etc) and speak with your injector about your concerns.

Darryl J. Blinski, MD · Answer

You bring up a very interesting issue. Dilution of Botox is variable per each injectors desires. Maybe you should ask for the exact amount of sterile sailing mixed with the units so you have an idea and then ask for more units to be injected in one area, like galbrllar, or crows feet, and see if it lasts more than 6 to 7 weeks. Or go to other injector and try their dilution pattern. Or try another product than Botox. There are other neuromodulators available. Good luck.

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