Was There Something Wrong with the Botox?

First round of Botox in my jaw (Masseters) lasted a good 4 months without movement, and my forehead/crows feet was still so good after 6 months that I asked the Dr before getting a top up.

Second attempt has barely lasted 2 months, and I have more movement in my forehead now than after 6 months last time. Also, it started working the same day this time... Friend has been getting it for 10 yrs, but used my Dr and has the same issue. They say it's normal and we need to get top ups. Not convinced..

Doctor Answers 8

Botox vs. Another Product?

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Other products, like Dysport, work more immediately after injection, but can vary in their longevity from Botox. Is it possible that you received another botulinum toxin muscle paralytic? I would check with your doctor and discuss your observations with them to search for an answer on this one. Best of luck! 

New York Dermatologic Surgeon

Botox lasting 2 months

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Your Botox may not have lasted as long this time if less Botox units were used.  It seems you were treated by a different injector the second time.  If the cost was less, fewer units were probably used.  If the appropriate amount was used, your effect should last longer than 2 months.  You should have your injections performed by an experienced certified dermatologist or plastic surgeon.


Martie Gidon, MD, FRCPC
Toronto Dermatologist

Different duration for botox on second administration

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Was it Botox or another botulinum toxin you got the second time? If different, were the units equivalent to that used in Botox? Was the botox fresh and stored correctly? Did you get the same number of units the second time? These are only some of the variables that may have affected your result. Discuss them with your doctor.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Talk with your doctor

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There are so many possible reasons for this difference, many included below, that it would be wise to talk to your doctor.  Based on your discussion, you'll be more likely to be able to determine the cause of this change.  It does sound more like a temporary issue, so hopefully next time will work out better.

Victoria W. Serralta, MD
Arlington Dermatologic Surgeon


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This raises an interesting issue

Some patients can develop Botox resistance. They require either higher or more frequent doses of Botox.

Without examining you and having information about your prior treatment I cannot comment on it

Paul Carniol, MD
Summit Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Botox not working in the same way

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All good feedback from panel members.  We would suggest that, first and foremost, you discuss your concerns with your physician.  We invite all of our patients to return in 2 weeks to make certain that the desired outcome was achieved. 

Without knowing the number of units of Botox that was used in each scenario, it's difficult to suggest that the physician was not being forthright or ethical.  We would encourage you to be more proactive in directing these questions to the MD, and if you are not satisfied with his/her explanation, then it's time to find another practitioner.

BTW, we strive to produce good, expected outcomes with each Botox treatment so that "touch ups" are not considered as routine.  You should expect the same as well.


Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Botox results for wrinkles

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There are a number of possibilities that could have given you a different result. As stated above, it could be that you did not receive the same number of units this second time around.  Another possibility is that the Botox was reconstituted differently. Botox is very labile and if it was mixed more vigorously or sitting in a syringe for a longer period of time, it may not be quite as effective. Another possibility is that you were much more active after this treatment. There is some anecdotal data to support that those that do a lot of weight lifting do not get the same longevity out of their Botox. The placement of the drug may not have been the same.  It is difficult to reproduce the injection process in the exact same way. Discuss this with your Doctor in a non threatening way and he or she will most likely give you some kind of compensation in a price reduction for your next treatment. 

In a effort to make a profit some doctors get stingy with the BOTOX.

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You need to know you are getting what you pay for.  Your doctor should tell you flat out how many units of BOTOX you are getting that way if the duration of the effect is not to your liking and you want to compare with another doctor's method you can compare apples to apples.  If you can't trust the doctor to treat you will the dose you have paid for, please find a different doctor to do your service.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 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.