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.