I Have Had Botox 4 Times in the Last 4 Mouths and No Change. What Can Be Going on with Me?

Doctor Answers 14

Botox results

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You may want to seek a second opinion for your injections. However, there have been reports of decreased effectiveness in some patients, and this may be what's happening with you.

Botox Resistance

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   Botox resistance does occur and is reported.  This usually occurs after years of use.  Dysport or Xeomin could be used in the future.

Botox not working - quite rare

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Quite rarely some patients don't respond to Botox or lose response to Botox over time. I would first ensure that you are indeed getting Botox from a reputable and highly trained physician as I have seen several "non-responders" who were in fact probably getting saline injected into them rather than real Botox. If you genuinely are not responding to real Botox, I would then try one of the newer preparations of botulinum toxin such as Xeomin. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

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Botox Resistance

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It is extremely rare, but possible to develop resistance to botox. When it happens, it usually is related to doing repeat doses soon after previous doses. Assuming that the dose that you had was appropriate and you are resistant, other types of neuromodulators (botox type medicine) may still work on you.

Botox 4 times in 4 months

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You should speak to your injector and look at your before and after photos to see if there really is no change.  Botox helps relax dynamic movement of muscles so if it is not injected into the correct muscles you will not have the desired effect.  Make sure you have treatment with a board certified dermatologist or plastic surgeon who is an experienced injector.  It is less likely that you are not a Botox responder, but if so, other neuromodulators could be tried.

Martie Gidon, MD, FRCPC
Toronto Dermatologist

Botox not working?

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It is very unusual to be immune to Botox - usually about 1:10,000 people do not respond or only minimally respond.  Have all of your injections been by the same injector?  How many units were injected?  What area of your face was injected?  Are the lines you are looking to treat static or dynamic?  All of these questions need to be answered to give you an informed answer.  If you truly are not responsive to Botox, then there are alternatives within the same class such as Dysport and Xiomin and other classes such as Myobloc which can be tried.


Good luck.

Botox 4 times in 4 months?

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If Botox is not working after repeae injections, it is unlikely that the Botox would not work.  You may want to consider seeing another injector.  More information and details of your goals and how you were injected would be helpful.  An exam is also  key.

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

No change following Botox treatment

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I would recommend speaking with your provider. If Botox is not working for you, I would suggest trying something different. Dysport is a great alternative, and  may be a good option. It has a faster onset than Botox and lasts slightly longer as well. I hope this helps, and good luck!

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

You may be resistant to the Botox brand. Try Dysport or Xeomin

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Some people become resistant to the Botox brand.  Try Dysport or Xeomin. they will likely work for you.  I am personally resistant to Botox, but Dysport works great for me.  My resistance occurred after ten years of Botox use.

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.2 out of 5 stars 18 reviews

Botox-no change after four treatments

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Something here ius not quite right and it can be several things. One could be that what you are expecting to happen is not something that Botox will correct. Example-Some people have such big smiles and loose skin on lateral cheeks. All the Botox in the world might not prevent some wrinkling with a big smile. Secondly, you might not be getting enough. thirdly , you might not be getting Botox or it is not being injected properly. I would try another  injector and make sure that they are an experienced physician.

Jo Herzog, MD
Birmingham Dermatologist
4.8 out of 5 stars 20 reviews

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.