Botox, Was I Scammed? (photo)

Question

I have received Botox only 3 times in my life --11/11, 4/12, and a week ago (6/3/13). All were sold to me as 20 units of BOTOX. The first 2 times I absolutely loved my results! I was seated up right, had no bleeding, saw results in 3 days, and lasted 6 months each time! This last time was at essentially bare &everything was different. It's as if I didn't get Botox at all! I am angry! Have I been scammed or is there a possibility that I already need a higher dose!?

William J. Hedden, MD · Answer

I would not be so quick to blame the injector as some have. Botox does occasionally have bad batches as any practice that does any significant amount would know. But Allergan the company that makes Botox will replace the amount that did not work. You just need to return to your doctor early enough after the injection for them to report it to Allergan. But any good doctor should take care of you. Good luck:)

Nelson Lee Novick, MD · Answer

I have considerable experience using Botox for aesthetic purposes, having started doing so in 1991, eleven years prior to its official FDA-approval for this purpose. Throughout that time, from time to time, I have encountered individuals who had at first responded well to treatment, but who, after two or more prior treatments, demonstrated either no response, weaker response or shorter duration of response.

	The medical literature estimates the development of antibodies in the range of 3%-13%. However, it seems that  even among those with proven antibody formation few actually demonstrate any significant loss of responsivity to further treatments. This of course does not rule out that some may indeed do so and this fits my own experience in twenty-one years of injecting Botox for dynamic wrinkles.

	An increased chance for promoting antibody formation may also be related to the routine practice of bringing patients back after just two weeks to touch up any areas that may not have completely responded to treatment. For this reason, it is currently deemed wiser to bring patients back no sooner than a month following treatment for touch ups.

	When there exists no other obvious explanation for lack or response or loss of response or shortening of duration of response (such as changes in dosing or concentration, etc.), and antibody formation is suspected, a trial of Xeomin, another bolulinum neuromodulator would be reasonable.

	Xeomin is essentially a naked  Botox, stripped of the proteins that come attached to Botox that are believed responsible for triggering the development of antibodies. I have found Xeomin to helpful among the few patients I have had recently  in whom I have suspected antibody-related resistance, In such instances I have seen full responsivity restored.

	Although Dysport, the third approved botulinum neuromodulator available in the U.S. market, does contain additional proteins, I have nonetheless also found this product to be useful as an alternative in patients who appear to have grown resistant after several successful prior treatments.

Sam Naficy, MD, FACS · Answer

Based on your photo's, I would suggest following up with your provider. It may be that you either need more product, or the injections weren't done correctly. If you're visiting a reputable provider, returning for follow up is always indicated. Botox isn't intended to last 6 months.

Michael I. Echavez, MD · Answer

Did you have the same injector for all 3 Botox treatments?  If you had the same injector and the same dose, I would think that you should have the same result with each treatment.  If they were different injectors, then it's possible that the placement of the Botox is the issue and not necessarily the dose.  It is also possible that you do need a higher dose.  20 units of Botox is within the normal range for treating the glabella, but some people do need a bit more.

Cheryl A. Hull, MD · Answer

I can understand why you are disappointed with your results, Stephanie.  I always tell my patients that if they still have movement to a treated area after Botox, it is more often related to injector's placement or technique rather than Botox itself.  Did you have the same injector each time?  I highly recommend you return to your injector and discuss your results.

Botox, Was I Scammed? (photo)

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Botox, Was I Scammed? (photo)

Answers (10)

Answer: Poor Botox result

Answer: Poor Botox result

Answer: Botox Results

Answer: Botox Results

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Everything you need to know about Botox

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