Botox (as well as Dysport and Xeomin) results are not lasting?

Botox always worked well for me. I took a break for 2 years while pregnant/nursing and now no matter what I try (Botox, Dysport, Xeomin) the results don't last more than 6-8 weeks, tops. Any suggestions or alternatives?

Doctor Answers 16

Resistance to neurotoxins is rare

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You can build a resistance to BOTOX, but it’s rare. With the newer BOTOX formulations, very few people (less than 1%) really develop a true resistance to BOTOX. Some people who have had a resistance to BOTOX have had good results when they switch to a different neuromodulator like Dysport or Xeomin.  In your case, if you don’t have lasting results, it may be because you’re not getting enough product.  Or, the reason may also be the injection technique and the amount of product being injected.  Also, some patients just respond less well to BOTOX overtime. Your options are changing the dose, finding a different injector or trying filler instead (sometimes using filler along with BOTOX can make results last longer), or surgery.

New York Oculoplastic Surgeon
4.7 out of 5 stars 68 reviews

Botox not lasting

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I would recommend looking at the dose pre baby and then the doses you have been getting of the three toxins. If the dose is not high enough it will wear off too quickly.

Hope this helps.


Dr. Rabach

Morgan Rabach, MD
New York Dermatologist

Duration of Botox

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There are several important points to consider. First, a picture would be helpful. Sometimes botox in combination with fillers can lead to longer duration for both. Second, which areas are of concern. Some areas respond better to botox than others.  Third, how many units are you getting injected?  Sometimes you may need more injected. What worked 2 years ago may not work now.  Finally, it could just be you and the duration of action is 2 months. While most clients will enjoy 3 to 5 months, not everyone falls within this range

Hardik Soni, MD (not currently practicing)
Summit Emergency Medicine Physician

Botox Combined With A Filler Tends To Last Considerably Longer Than Botox Alone

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I have been injecting Botox since 1991 and during that quarter of a century I have encountered quite a few individuals who appear to have developed some resistance to its effects. Most of these, however, have demonstrated adequate responses to equivalent doses of Dysport and particularly Xeomin. From your story, it does seem reasonable to posit that you have developed some measure of resistance. One possible approach to dealing with this is to increase the concentration and/or the dosage of Botox (or the two others). Another approach is to combine the use of the Botox with a filler. This has been particularly successful in dealing with frown lines, and I have likewise found it quite gratifying when used in the crow's feet and forehead worry lines regions. As an aside for other readers of this response, I have found that an initial series of between four to six Botox, spaced at fixed four month intervals, to be extremely helpful in helping to prolong the intervals between treatments, in studies between 24-36 months. And this has become my standard recommended approach when treating patients new to Botox. I hope this helps. Best of luck

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Botox and dysport

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Most of may patients go about 3-4 months between treatments, but I do find some that need it more frequently. I have seen this in some very active people like personal trainers and marathon runners.

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

Neuromodulators aren't lasting

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is possible you have develop resistance to these. I would try higher dosing. I have some rare patients that just require every 2 month treatments though.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Why isn't Botox lasting?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thanks for your question. Botox and Dysport typically last 3-4 months. The first thing to do if patients find that Botox is not lasting as long as they want is to increase the dose and to be seen 2 weeks after injection to evaluate. I recommend you see a Board Certified Plastic Surgeon or Dermatologist for evaluation and treatment. I wish you the best.

Short lasting results

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

That must be so frustrating for you, sorry to hear. While some people do develop resistance to Botox, this is rare and usually seen in people with muscular disorders that are receiving very very large doses.  If it is working for you, but not the effect is going away too quickly, that does not sound like resistance.Since you have already tried switching types, my best guess is that there is a problem with the injection technique.  It may be that the injection is going slightly too deep or too superficial and not getting into the muscle directly.  You may need a different injector and a higher doseBest of luckDr Rodman

Regina Rodman, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

How long does Botox last ?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I have had the rare patient in whom Botox lasts > 9 months. In general, patients return for Botox treatments every 3-4 months. It is possible that you are one of those patients that needs a larger dose of Botox. Dr Hratch Karamanoukian

Injectable botox/dysport/xeomin

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
There are three possibilities that might explain your situation. 1. You for some reason now metabolize botox differently than before and break it down sooner. 2. Your body has developed some sort of resistance to it (this is very very rare) or 3. You might benefit from higher doses. Make sure you are seeing a dermatologist or plastic surgeon for best results.

Omar Ibrahimi, MD, PhD
Stamford Dermatologic Surgeon
4.9 out of 5 stars 29 reviews

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.