Thank you fro your question. Its is very rare; however, it is possible. You may require a larger dose. I'd recommend booking a
consultation with a skilled and qualified injector to discuss your
There are a few reasons why botox works better for some people than others. It is possible to be resistant to botox, but it is uncommon. The way the botox was diluted can have an affect on the duration as well as a patient's metabolism. It's been know that botox doesn't last as long on patient's with higher metabolisms. I would recommend going back to your practitioner to discuss your concerns.
Although theoretically possible for someone to be completely resistant to Botox, it is extremely rare. I have never noticed it in treating thousands of patients over 20 years. There are probably more likely scenarios. Possibly, Botox was reconstituted with water incorrectly diluting it to a very low dose. Do remember that Botox dosing is correlated with muscle mass. If you have significant ability to wriggle your for it with a larger than normal frontalis muscle, you may require more Botox than average. Discuss your concerns with your plastic surgeon.
Thank you for your question. It is possible for to be resistant, but it is also rare. I would recommend visiting your surgeon for an examination.
Acquired resistance to botulinum toxin is possible, but uncommon, and it occurs to the binding proteins accompanying the toxin. Resistance is more commonly seen in patients receiving high doses frequently, i.e. for medical reasons. If you tried Botox Cosmetic the first few times, try another formulation like Xeomin or Dysport. Xeomin has no binding proteins with it so resistance is uncommon. Also remember that people metabolize medications differently, so some never get results for four months. Initial results from botulinum toxin have a lot to do with concentration of the product and placement. This requires an experienced injector. Occasionally, a batch of botulinum toxin can be weaker or inactive. This could explain your initial poor response to treatment. Good luck!
It is certainly a possibility though not very common. all patients make some degree of antibodies against Botox when injected but the effects remain subclinical. Rarely, are there patients who do not get a response of any significance or none at all. it would do no good to switch to another form of the toxin
I have definitely seen over the years that patients metabolize the product differently. It could be that less product was used or the batch wasn't as strong as another. I would return to your treating physician for examination. Possibly Dysport would be a better alternative if this happens again. Best, Dr. Green
I agree with the other Dr.s. I would certainly try dysport or Xeomin. However,'I have found that my patients typically need 30% more Xeomin units compared to Botox. Dysport has also worked well in my patients with reduced or no response from Botox.
I have found that patients that are very active ( marathon runners, triatheletes, personal trainers) tend to metabolize it quicker.
Complete resistance to Botox is highly unlikely. And it does not appear to be the case here, since you said you initially had a good, if somewhat slow, response to your most recent injection. Response is related to muscle bulk and strength, which is why some people need more Botox in an area than others. Different people do recover at different rates, as well, so some people find the effect wears off faster. Finally, Botox and Dysport have proteins combined with the toxin. People can have an immune response to those which makes the product less effective. You might try Xeomin, which is pure toxin, without protein, and see if it works better.