Why Didn't Botox Work on my 11's?

If you have had Botox injected three times with no effect then you may not be receiving the correct treatment for your issue.  If you post pictures of your face we may be able to give you more specific advice.  Botox works on dynamic wrinkles - meaning wrinkles caused when muscles contract.  If your "11s" are severe enough that they are also there at rest, then you may have dermal atrophy requiring treatment with a dermal filler such as Juvederm.  For static wrinkles - wrinkles at rest - Botox will not be effective during the first few rounds of treatment.  Over time, however, the decreased activity of the muscles may allow some of the dermal atrophy to heal and show an improvement in the static wrinkles as well.  It is very rare to be "immune" to Botox.  While it does occur, it usually only happens in 1 out of 10,000 patients is often in patients with long time exposure to Botox.

 

Good luck.

Botox relaxes the muscle of facial expression which cause wrinkles.  However, if these wrinkles are very deep you may need a combination of botox and facial filler.

If the muscle is not moving at all when you frown, but the lines are still there, then adding more units of botox will not make your "11" go away. With some deep glabellar folds, we see that they continue to improve for months (they've been created by years and years of muscle activity) and it can't go away "overnight" so you maintain botox injections before they wear off every 3 to 4 months and the deep folds start to relax after a few cycles. Other patients will need cautious filler injections in addition to Botox.

However, if the muscle is still moving despite three treatments, then the questions are:

1. Have enough units been used at one treatment? Some patients will need 25 to 35 units. It depends on the anatomy of their muscles.

2. Is it Allergan, FDA-approved Botox?

3. Are the correct muscles of the glabella being injected?

Botox dosing requires a certain degree of titration from patient to patient to match the physical changes and expectations present.  I inform patients that my goal is to achieve a relaxed look at rest, which still allows for some motion. If a patient desires "no motion" in the glabella, a higher dose of Botox is administered.  However, in some patients, these hyper dynamic lines are so deeply etched that Botox alone is insufficient.  Various Fillers can potentially be used in the glabella, but are not FDA approved for this purpose, and have been associated with specific complications.

Hi VE.  There are a couple of possibilities, but assuming your injector is capable and there is a suitable does of Botox injected, it could be that the lines are too deep for Botox alone.

In some instances, using Botox alone will not completely resolve the frown lines you noted as the "11's".  In these cases both Botox (or Dysport) and a dermal filler like Restylane or Juvederm is required.  When the vertical lines are too deep, the Botox is often not enough and the area needs to be plumped or filled with these other products.  You may want to ask your injector about this, but it shoal have been discussed beforehand if this was a possible outcome.

Botox relaxes the facial muscles which contribute to the 11's, or vertical wrinkles in-between the eyebrows. Botox  may take up to 2 weeks before the maximum effect. While most patients respond to typical doses, some patients require more Botox than others. Lastly, Botox may not completely eliminate the facial wrinkles and complimentary treatments such as Restylane or Juvederm may be required. Other options may include skin care, subcision, dermabrasion, or chemical peel. Only after a comprehensive evaluation can a plastic surgeon or specialist help determine appropriate options for you. Best of luck.

Dr. Chaboki

 

There are several reasons that your Botox was not as effective. Your lines may be engrained in your skin and will take successive treatments. The best way to tell if the Botox is working or not is to try and scowl or frown. If you cannot make that movement while looking in the mirror, then the Botox indeed worked but it may take repeated injections for the lines to eventually fade out. Another option would be to consider some filler in there in addition to the Botox to maximize the effect. There are rare people who do not respond to the Botox but that is very, very uncommon.

Dear Veggieeater

First if you just got more BOTOX, you should wait another 10 days before throwing in the towel.  Also you have not stated how much BOTOX you reiceived.  This is measured in units, not areas, or syringes.  The fact that the doctor reinjected you suggests that they are not being totally straight forward with you.  FInd out how much BOTOX you have actually be treated with.  Also there are some people who don't just have a muscle line but they actually have creased skin.  The skin crease is like a crease in leather.  The botox will not take it all away.  

Dear Veggieeater,
Thank you for your question. Botox relaxes the muscles that cause the wrinkles.  However, when dealing with very deep lines you may find a combination of botox and filling the 11's with a small amount of filler gives you the best outcome.
Always use a qualified Facial Plastic Surgeon for these treatments to ensure the safest and very best results.
Hope this helps! 
Best Wishes,
Mr Kambiz Golchin

Thank you for your question! I have used Botox for over 20 years and it is does dependent which means some people get a great result with small doses while others require quite a large dose for the same effect.  If you really hate the Glabellar lines, there's enough Botox to get rid of them, just increase the dose. Best of luck!