Can Botox stop working after regular use?

Question

I've been getting Botox injections for a year and a half now and have always had good results with no movement for up to 3-4 months. My recent Botox injection of 20 units (regular amount) showed movement in the treated area right afterwards making lines and wrinkles show up. Is it normal for Botox to stop working after regular use? Is my body immune to it or is it a case of 'diluted' Botox? I have been going to the same clinic since I started and never had any problems.

Corey S. Maas, MD · Answer

The simple answer is, “yes, but it is rare”. Perhaps
you need a higher dose of Botox, or you can try to Dysport or Xeomin.  My exxperince is that optimum results are
often NOT achieved when anatomy is properly considered. It is important that
Botox be injected into the proper muscle group. In contrast to popular belief
your doctor (or a nurse that they directly supervise) should have the best
grasp on your specific condition, and use this knowledge for placement and
dosage accuracy.  An optimal response can
be achieved using minimal dosages with proper placement in the appropriate
muscle groups. By understanding the facial anatomy, one can use Botox not just
for wrinkles, but also as a treatment to reshape and soften certain facial
features that can be associated with frowning, anger, or just simply aging. In
order to determine if you would benefit from retreatment with Botox, a proper
physical exam is necessary.

Jerome Edelstein, MD · Answer

Hello, Thank you for your question. Very rarely does Botox stop working for patients. Perhaps you could speak with your qualified injector for alternate option, such as Dysport. You should also discuss your concerns with your injector. Take care.

Otto Joseph Placik, MD · Answer

While increasing the dose may be needed in some individuals, this is not typical of the average patient. Perhaps try switching to Dysport or Xeomin.

Jason Emer, MD · Answer

I find it extremely rare for botox to stop working in patients, resistance is really rare. I suggest you speak to your dermatologist or plastic surgeon or try another product like dysport. Best, Dr. Emer.

Young R. Cho, MD, PhD · Answer

Thank you for your question. Although people to develop resistance to Botox, this is a very rare. I would recommend that your revisit with your injector. There are some variations of strength from one vial to another, or mild variations in the injection technique even for the same injector.   It could be something as simple as different steps being used in different injection sessions, leading to a different amount of weakening of specific targeted muscles.

Otto Weiglein, FRCSC · Answer

Your question about building up immunity to BOTOX is one
that is asked fairly often at my practice. There is virtually no research
suggesting that this type of reaction occurs. In fact, there is research
suggesting that long-term use of BOTOX can actually cause its effects to last
longer, meaning a patient needs less frequent treatments to maintain results. You
mentioned that you were seeing movement "right afterwards" following
your procedure. BOTOX usually takes 7 to 10 days to show results. Is it
possible that time had not passed? I would recommend talking to your injector
about your results to see if he or she has a good explanation. Thanks for this
question.

Quenby Erickson, DO, FAAD, FACMS · Answer

Botox rarely stops working, there is likely another reason why it didn't work for you this time.  I would return to the clinic and give them the opportunity to trouble shoot this and perhaps re-treat it. I hope this helps!Dr. Quenby Erickson

Gustavo A. Diaz, MD · Answer

Botox resistance is a very rare condition. The most common problem is that the muscle was missed or a problem with the dilution of the product. Consult you physician injector.Hope this helps,Dr. Gus Diaz

Julio Clavijo-Alvarez, MD, MPH, FACS · Answer

Thanks for sharing your question.  I can appreciate your concern and agree with
your assessment.

Resistance to botox is very rare.  Most of the times the variation of the
results are due to the botox brands and the dilution used for your injection.
If you got the units that you paid for, you should have similar effects.

Make sure to have an evaluation by a board certified plastic
surgeon or dermatologist.

Best wishes

Karol A. Gutowski, MD, FACS · Answer

Botox resistance due to antibodies is rare. More likely, you may just need an additional injection this time to correct the problem.

Can Botox stop working after regular use?

Answers (12)

More Botox Questions

Does botox give any weird feeling after it is injected?

Angry looks after Botox a week ago on forehead and near my eyebrows. Is this normal? (photos)

When getting botox injections in the forehead does a patient feel the after effects?

Can pressure from a snorkel mask on my forehead cause any migration problems after botox injection 4 or 5 days ago?

Will my cheeks go back to normal after masseter muscle Botox?

How long before and after Botox is it safe to have Viora Reaction radiofrequency treatment on face?

WE SEND PRETTY
EMAILS