Injection to Dissolve Botox?

Question

If Botox is administered incorrectly, like Juvederm, is there something you can inject to counteract the effects and dissolve the Botox?

Yannis Alexandrides, MD, FACS · Answer

Botox is non-permanent and so the substance will naturally dissipate within 3-6 months with the effects wearing off with it. Unfortunately, unlike with fillers there aren't any substances currently available which can dissolve the toxin.

Mitchel Goldman, MD · Answer

Botox is not a filler, like Juvederm, and cannot be dissolved. Once it has been injected into the muscle, the muscle will relax and continue in a quiescent state until the neuromodulator wears out in about three to four months. This is why it is so important to find an expert injector with many years' experience with Botox: You don't want to risk a mistake that will take months to resolve. Please consult a board-certified dermatologist with expertise in Botox injection.

Jerome Edelstein, MD · Answer

Unfortunately, the best thing to do if you don't like the results of your Botox treatment is to simply wait it out. Botox isn't permanent so in a few months, the treated area should return to its pre-injection state. This can take about 4 months or so, depending on your unique physiology and the area in which it was injected.

Harold J. Kaplan, MD · Answer

Unfortunately, as the panel has suggested, there is no way to reverse the effects of Botox as there is with hyaluronic acid based dermal fillers.

	Depending on the injection area, there may be ways to improve the appearance of the injections.  For example, if we have a patient that has heavy lids from a Botox injection, in some cases we are able to lessen the appearance of the problem by performing a Botox browlift.  But in many situations, the answer is just time.

Raffy Karamanoukian, MD, FACS · Answer

There is no specific medication or technique to reverse Botox. Botulinum toxin serotype A is an irreversible inhibitor of Ach release at the neural synapse and cannot be countered once injected.

Kenneth D. Steinsapir, MD · Answer

Dear Hollybrook
It is important to undertand that there can be some significant problems if BOTOX is not properly placed. For this reason, you should be certain that you are getting treatment with a core aesthetic physician or surgeon who understands facial anatomy. This means seeing a specialist who is board certified in one of the following areas: Dermatology, Ophthalmology, Otolaryngology or General Plastic Surgery. However, this is not sufficient to assure yourself of the best possible treatment. 
This is one service that is best done by someone with a large body of experience.  You do not want to be their second patient.  
You BOTOX treatment can be adjust by an experience injector.  Also the peak of your treatment will occur in about 3 weeks. After this, the treatment effect will begin to wear off.  At about two month a correctly placed treatment can placed.

Eric M. Joseph, MD · Answer

Unlike hyaluronidase which will dissolve Juvederm / Restylane, there is no injectable or topical medication to reverse the effects of BOTOX.
Most of the common BOTOX-related problems like droopy eyelid or eyebrow assymetry can be improved, and all BOTOX-related problems are temporary. A droopy eyelid will last for around 4-6 weeks and can be alleviated with Visine (phenylepherine) eye-drops. A funny looking brow can usually be treated with a BOTOX dose-adjustment.
Best regards.

Michael A. Persky, MD · Answer

Hi Holly,
There are not Botox reversal agents.  Tincture of time is the only treatment.
Now if a patient has the "Joker or Diablo" arched eyebrow look of poorly placed Botox, that is correctable by injecting a small amount of additional Botox laterally in the forehead.
Choose your injector carefully.
Dr. P

Otto Joseph Placik, MD · Answer

There are no known methods of reversing the effect of Botox on a muscle.
In some instances the effects can be lessened by injecting the antagonist muscle or stimulating an agonist muscle but this is not a true reversal of its effects.

Melda A. Isaac, MD · Answer

Unfortunately, there is no antidote to Botox's muscle-relaxing effect. If you have a bad outcome, the only remedy is patience. It takes about three to four months for Botox to wear off on its own. Please be sure to only work with a board-certified dermatologist who has been trained in Botox administration, has expert injection technique, and many years' experience.