Botox Does Not Work for Me - What Can I Do?

I tried Botox four times and only the first time I saw that my face was peaceful looking but this lasted two days only. What can be done to help me be rid of my angry expression that I constantly have? I feel my muscles in my eyebrow area are so tense and I can't do anything to relax them.

Doctor Answers 21

If Botox doesn't work try adding filler or using Dysport instead.

I hope along with your Botox trials you are also doing things in your life to make sure you can feel relaxed and not feel tense. If your eyebrow muscles really are tense and a neuromodulator is what you need, it's possible your injector is not using ENOUGH Botox in the right locations, or else you may do better using Dysport instead. Some patients respond better to that when Botox doesn't seem to take.

Finally, if the Botox prevents you from moving the muscles, but you are distressed by still seeing skin folds and creases that sit there.... you may benefit from adding a small amount of filler right under the creases to boost the immediacy of the Botox effect and to act synergistically together for a faster and longer result. See your board-certified dermatologist or plastic surgeon for help.

New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

Botox is best injected over multyiple treatment sessions.

Botox is best injected over multiple treatment sessions. The total dose and the placement of botox determines the effectiveness of the treatment and therefore better results may be achieved with multiple injections over a period of weeks.

Edward Lack, MD
Chicago Dermatologist
2.8 out of 5 stars 5 reviews

BOTOX working

The angry look to which you refer is usually due to the "number 11" lines forming between the eyebrows in an area referred to as the glabella.  If you notice decreased movement of the muscles in that area, the problem may be that not enough BOTOX was injected, too much time passed after the BOTOX was made , and/or that it was not injected in the right location.  If the issue of concern are the lines that remains even after minimal or no muscle movement is achieved in this area, then the "static wrinkle" that remains may be best addressed using other treatments such as injectable filler materials or lasers.  It may also be beneficial to try other medications similar to BOTOX such as Dysport and/or check to see if you have antibiodies to BOTOX.

Adam Schaffner, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 58 reviews

Botox on the glabella

Botox is usually very effective on the glabella region.  Maybe enough was not inejctd. You may also want to consider Dysport instead.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Botox Treatments

Thanks for the question.

I have never heard of anyone having such minimal effects to Botox Cosmetic as you are describing. Perhaps you are being under treated. Without knowing your exact dosage for the given area, its difficult to say. You may want to try an alternative to Botox Cosmetic such as Dysport. Alternatively, you may want to consider a different clinician to get your treatment.

Best of luck,

Glenn Vallecillos, M.D., F.A.C.S.

Glenn Vallecillos, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 31 reviews

Botox usually works

Some people need a high dose of Botox to achieve a good result. We have not had any patient who did not respond to Botox treatment.

Robert Kasten, MD
Mainz Dermatologic Surgeon

If Botox "doesn't work", try Dysport

Botox that is injected in the correct dosage, location, and is not "old", should work on almost everyone. In some persons, whom have usually had previous injections of Botox, antibodies may inactivate the Botox. You might try Dysport, another botulinum toxin that has recently been approved for use in the US, (although it has been in use in Europe for longer than Botox has in the US). Some clients that are "resistant" to Botox have had good results with it, and many offices routinely use this neurotoxin.

Debra Irizarry, MD
Crestone Plastic Surgeon
4.2 out of 5 stars 5 reviews

Botox not working for you

It sounds like you are describing Botox for the treatment of frown lines.   I am sure that there are some patients who will not respond to Botox in this area (this is biology after all), but I have not found one yet.   The incredible thing about Botox (especially in this area) is how incredibly consistent the results are (how long it lasts is not as consistent). 

If you have had more than one respected physician (preferably dermatologist or plastics) inject you and still not gotten a response, try Dysport (another brand of botulinum toxin).

Also, remember that Botox treats muscles (that cause wrinkles) but not the wrinkles themselves.  So if you are still able to frown, then the Botox did not work.  But if you are unable to frown, but still have a line (especially if it is a deep line that is present even when you are not frowning), then the Botox "worked" but the line may be too deep to treat with this method alone.    Often, even these lines will soften with time if you maintain your Botox.

Todd Minars, MD
Miami Dermatologist
3.7 out of 5 stars 6 reviews

Botox Does Not Work! What to Do?

Hi Sydney.  In the hundreds or thousands of Botox patients we have treated, we have had only one that seems to be resistant to Botox and this is actually one of our nurses that used the product more often than is recommended.  

So, with that said, it could be one of three things.

  • Improper injection technique
  • Not enough Botox
  • Dermal filler needed because frown lines are too deep.

Regardless of which one of these it is, we think it warrants getting a new injection professional as all relate to a practitioner that is not guiding you well.  Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

Botox doesn't work for everyone

Botox is an excellent treatment for dynamic wrinkles, but there are several reasons why it may not have worked in you. First, the injection technique and expertise of the injector. The number of units used, ideally determined by an expert injector like a dermatologist. Rarely, some people do develop antibodies to Botox and in this case it stops working; use of a different botulinum toxin would be suggested in this case. 

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.8 out of 5 stars 50 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.