Age 60, opinions please as I get no results at all from Botox, Dysport, Xeomin? (Photos)

Question

I am 60 years old, average height and weight. I have I high tolerance to everything, drugs, novacaine, anesthesia etc. I've had botox, Dysport, Xeomine, juviderm and Rystaline injections over the past few years.. Absolutely NO DIFFERENCE from any of them

Jason Emer, MD · Answer

If Botox is not an option for you, Dysport or Xeomin are the next options. I suggest dermarolling at home to give the skin Botox-like effects with at-home treatment. See an expert. Best, Dr. Emer

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. If you’re interested in continuing with non-surgical approaches, you may benefit from Sculptra injections or RF microneedling treatments to rejuvenate and lift the skin. 
Sculptra is a poly-L-lactic acid formula that can effectively stimulate the body’s collagen production and restore lost volume. RF microneedling also stimulates collagen production, while also increasing the amount of elastin and hyaluronic acid your body produces. Results from Sculptra injections can last for up to two years or more, while RF microneedling results may last for many years in some patients. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or injector. They will be able to review your treatment history, discuss your concerns and aesthetic goals with you, and develop the best course of action.

Thomas Trevisani, MD · Answer

In person exam is needed. Depending on what your ultimate goal is - the treatment will be outlined. If you are trying to rejuvenate your face - fillers and Botox may not always be the right solution. Based on limited photos, it appears that you would benefit from a brow lift, upper+lower lid blepharoplasty , facelift/ neck lift - in order to achieve the best long lasting result. After that non surgical treatments can be added to maintain the most youthful look. I suggest that you seek an experienced Board Certified PS

Nelson Lee Novick, MD · Answer

At least from the photos I can see nothing unusual about problems you have. In fact, what I see is something that any cosmetic dermatologist sees and treats practically every single day. First, there seems to be quite a bit of volume deficit in the cheeks responsible not only for flattening and sinking of the cheeks themselves, but secondarily causing the under eye issues, smile lines and even the marionette lines to the sides of the mouth. Ordinary Juvderm or plain Restylane, both best reserved for simple more shallow lines and wrinkles, would not be expected to do much, especially if only a syringe or two was used. Restylane Lyft or Voluma XC would be more appropriate for treating these issues, especially when a sufficient quantity is used to achieve the "liquid facelift" effect. Properly performed, the results would be immediate and would very likely elicit from you an immediate "Wow!" reaction.  As to why you have not responded to any of the neuromodulators (Botox, etc.), this may well relate to the either the technique used by the injector(s) or to the dilutions used. If overly diluted, they do not work well or at all. You would be wise to consult an experienced, board certified cosmetic dermatologist injector to ensure that you are being treated properly and adequately. Hope this helps.

Chuma Chike-Obi, MD · Answer

It is possible to have primary resistance to botulinum (#Botox, #Dysport, #Xeomin, #Daxxify).This means that treatments with any of these products have never had any clinically meaningful effect on you.The most likely cause for this is that you have developed antibodies to the botulinum protein somewhere along the way. Possibly in infancy. You see, some people are asymptomatic carriers of the clostridium botulinum organism that makes the 'botox' toxin.
I suppose it is also possible to have some sort of genetically related resistance to botulinum.
It is probably best to visit a trained clinician in your area for further guidance.
Good luck!Dr. Chike-Obi

Camille Cash, MD · Answer

If you have had no improvement from the treatments you mentioned you may want to look into surgical options such as upper/lower blepharoplasty and facelift.  The issue may be that some of the areas that you are treating have lines that are present regardless of muscle activity.  These will have minimal to no improvement from products such as Botox

Darryl J. Blinski, MD · Answer

If you have tried all these non invasive options then best to consider surgery. Full Face/Neck lift SMAS, quad blepharoplasty, release 11's, Fee $20,000+ Best to virtual consult with...

Samir Shureih, MD · Answer

It is not very common to NOT have any effect from different Neuromodulators.
Make sure the injector is a Board Certified Plastic Surgeon, not an assistant and not just any injector. The neurotoxin is fresh and not expired and Mixed and prepared fresh. After analysis of the area needing neuromodulator and the muscles involved then can inject the involved muscles. (this can vary from person to person). Your pictures show very pronounced etched lines that will continue to be prominent. May need a combination of fillers and neuromodulator.

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!From your photos, I note significantly lax facial skin with the formation of "11's" between your relatively low hanging brows, lax upper and lower eyelid skin associated with "bags", the formation of jowls and marionette lines, perioral wrinkling, furrows of the lips, and loose hanging skin of the neck. Injectable fillers and muscle paralyzers will work for minimal-moderate skin / soft tissue imbalance, but there is a limit to its ability to achieve improvement as the facial aging process continues, and gravity slowly takes its toll on our skin and soft tissues. It takes more and more product to achieve a result until it no longer seems to have an effect. You appear to have reached that point.A full face and forehead lift, neck lift, and peel of the lips may be required to improve your appearance.Visit a board certified plastic surgeon for evaluation and discussion.Best wishes...

Jose Ramiro Hurtado Vidal, MD - Account Suspended · Answer

Buenas tardes, usted es candidata a una cirugia de rejuvenecimiento facial, le incluye blefaroplastia que es eliminar la piel flacida de parpados superior e inferior, asi como el estiramiento de cara y cuello. Ese es el motivo por el cual no ha visto resultado con el botox y los fillers, porque necesita cirugia. Esperamos que esta informacion le sea de utilidad.

Age 60, opinions please as I get no results at all from Botox, Dysport, Xeomin? (Photos)

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