Botox: Did not work (first time user). Why?

Question

I went to a reputable CANS Injector for my first Botox exper. (forehead/11's).I went back at 2 wks and were both shocked-no affect on the area. She said it's unusual at the 2 wk mark (but it does happen).She was hesitant to- but did inject 4 more shots on my up. forehead.10days later-still no results.She was shocked. She treated my 11's with 3 more shots. I go back in a wk to recheck, but it's been 5 days and I can still make a frown.Do you have any exper. with pts not having results from Botox?

Nelson Castillo, MD · Answer

Thank you for sharing your question and experience.  After this many treatments you should have seen some response from Botox, and although resistance is rare, I would try another of the neuromodulators like Dysport or Xeomin to see if they work.  Hope this helps.

Aldo Guerra, MD · Answer

Thanks for sharing your experience. I have not seen this type of outcome in my years of practice. I would suggest you use a different product next time. Good options include Dysport and Xeonim.Best wishes, Dr. ALDO

Shaun Patel, MD · Answer

At this point you should be seeing some results from the Botox you had injected. I would consider another neuromodulator like Dysport to see if that works.

Melvin Elson, MD · Answer

This amount of material should have given results and it makes no sense to switch to another neurotoxin as Botox, Dysport and Xeomin are all botulinum toxin A resistance is also very unlikely. You might try seeking out a board certified dermatologist for injections. see melvinelsonmd.net for further information

Esta Kronberg, MD · Answer

I have on very rare occasions seen this happen. You may need more units than the average patient, or may need to switch to Dysport. Be sure they are using fresh Botox. Find out how long they save the product. It  is the most effective if mixed that day. This being said, I have on rare occasions had to really work with the patient with multiple trials to find the best dose and product for the patient.

Jo Herzog, MD · Answer

The first question to ask is whether the SAME bottle was used both times. If different bottles were used  then I would think it very unusual to have no response and would try Dysport or Xeomin. If the same bottle was used both visits there might have been a problem with that bottle of Botox.

Jennifer Trent, MD, FAAD · Answer

It is very unusual to have no effect from Botox.  I have never personally seen this happen.  I would go back to your physician and discuss it with him/her.  Perhaps try Dysport or Xeomin next time. Good luck! Always seek treatment from a qualified physician.

Leonard Grossman, MD · Answer

There is a small group of people who simply do not respond to the injection of any neuromodulators. However it is extremely rare. Without having seen you prior to the treatment and after the treatment it's a little difficult to make a recommendation besides asking the doctor to reconstitute a fresh vial of Botox and inject a higher amount of units that are well-placed in the anatomic area. Good luck from New York City

Michele S. Green, MD · Answer

If there is no effect from your Botox I would definitely return and have the area re-treated.  If there is still no effect I would try Dysport and see if you have the same lack of results.  Please let us know how many units were injection and keep us updated. Best, Dr. Green

Kristine Brecht, MD (license suspended) · Answer

Botox usually works great on the first treatment to relax the furrowed expression.
Work on relaxing your forehead, alternate muscle can still move.
Best. Dr Brecht

Botox: Did not work (first time user). Why?

Answers (10)

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