Botox Not Working After 16 Days?

I had Botox injections done 16 days ago. This was my first time ever getting it done. I had 15 units done between my eyebrows. I can still frown. There is absolutely no change. Very aggravating since I had to BEG my husband. And now hes saying the old "I told you so". I called the doctors office and they want me to come in for touch ups. I'm wondering if they are going to charge me more. If so my husband surely won't go for that! Grrrr any advise?

Doctor Answers 14

Non-effect from Botox

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The three most common reasons for your results are inadequate amounts, inappropriate placement, or placement of product that has gone bad (too much time since suspension). The region that you mentioned can vary in muscle density - greater density, greater amounts of neuromodulator. If the doctors office wishes for you to come in for a touch-up, this is a good sign that they want to do right by you and it is reasonable to return. I am unable to speak to additional costs, but you can easily ask and I am certain that no caring provider would be offended.
Be healthy and be well,
James M. Ridgway, MD, FACS

Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 98 reviews

Botox touchup

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You should see some improvement by now. Please return to your injector and discuss your concerns. They should be able to resolve your concerns to your satisfaction.

Touch up with no pay!

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They should fix free of charge.

You already pay for the service and should receive the treatment until the end. 

Eduardo Sucupira, MD
Brazil Plastic Surgeon

Botox treatment of frown lines in the glabella for the "11"

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Prior to injection of Botox for dynamic lines related to muscle movement, the anatomy of the patient is studied, both at rest and with active muscle contraction. A sense of the muscle bulk (mass) is made and the doctor can gauge how many of units are needed and how many insertion sites.  Many patients need more than 15 units for this region and the cost is more, depending on the total number of units. It is wise, however, to be conservative as one can always add more units.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Botox not working after 16 days - likely too low a dose

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I think the issue is that the dose given to you was too low. If you see an expert injector such as a dermatologist or plastic surgeon, they will ensure that you get the right amount of units, injected at the right depth, into the right anatomical place, and in combination with the right other treatments if necessary (e.g. fillers). Without seeing your frown lines, it is hard to say what would have been the right dosage, but I suspect it should have been double or so the dose you received. Dr. Benjamin Barankin, Toronto Dermatology Centre.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

Botox Not Working After 2 Weeks

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Botox takes up to 2 weeks to see the full effect. After 2 weeks, minimal improvement will be seen. For this reason, many physicians will recommend that patients return at 2 weeks to check the results.


Having "no result" after the treatment of Botox can occur for several reasons, including:

  1. Too little Botox was used. For the treatment of the frown lines, most patients require 20-25 units of Botox. Some patients, can have a good result with 15 units. This is the most common reason seen for results that are not optimal.
  2. Improper injection technique. The Botox could be injected into a blood vessel or in an area that does not get to the muscle required to see the desired effect.
  3. Bad Botox. The toxin is not very stable and can become less effective with time or if the bottle is shaken (hypothetical). 
  4. Antibodies to Botox. The toxin is surrounded by a protein, that one can develop antibodies to. In other words, the body recognizes the Botox as something foreign and fights it off.  This occurs after many treatments with Botox and is not common. 



Robert S. Bader, MD, FAAD
Boca Raton Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Botox and frowning

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Sometimes it take a little extra for the Botox to work.  As for the fee, that is something to discuss with your doctor.

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

The area treated was to soften the vertical lines or "11"s not prevent frowning

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Fifteen units between the eyebrows may be a little light for some people, and perfect for others. It will soften the vertical "11"s. You would need additional botox in the forehead area to reduce the ability to frown.

Other factors affecting results include technique, and freshness of the product. We use our botox within one hour of preparing.  

Christopher J. Peers, MD
South Bend Facial Plastic Surgeon

Botox timeline

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After two weeks, whatever Botox you had has reached its full effect.  The area you had treated between your eyebrows is the glabella, and the muscles treated in this area erase the presence of the "11's," the vertical lines present in the area of the glabella.


I usually treat the glabella with a higher dose than 15 Units, but that should be enough to produce some softening of the wrinkles.  Hopefully you had some photos taken beforehand for comparison.  Since you still have some motion in the area, it sounds like you do need a touch up.  Most offices do charge for the touch up, if needed, but they should be able to tell you what to expect over the phone.  


When properly dosed and administered, the glabella area gets consistent and outstanding results from Botox.  


Michael Bowman, MD
Roanoke Facial Plastic Surgeon

Botox isn't working...?

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Well the reason you can still frown is because you didn't have the forehead treated - you had the glabella area treated between your brows which means you shouldn't have those 11 lines there, but you absolutely should be able to frown because your forehead wasn't treated! The forehead muscles (frontalis) is what causes you to move that area and be able to frown. 15 units is a rather low amount for the glabella area - I use at least 20 units here. If the office that treated you wants you to come back for a touch-up I would ask them if they are going to charge you - different offices have different policies for touch-ups. Bur frankly, since you are going to really need treatment for an entirely different area - the frontalis muscle - this really isn't a touch-up, and probably will result in a charge. Sorry for that news.

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.