I don't think I was given enough botox. (photo)

Question

Had it six weeks ago have had two top ups and was told can't do anymore. I had two areas done. Frown lines and forehead but can still move both. I'm unhappy as she's now said I'm a mystery and nothing she can do.

Aldo Guerra, MD · Answer

I suggest you get a second opinion from another experienced injector if you feel you have exhausted your time with your current injector. You may also consider switching to another product like Dysport. Best wishes, Dr. ALDO

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question. You would probably be able to get rid of those lines with additional Botox. Make sure your treating physician is highly experienced with BOTOX.Good luck,

Shanthala Shivananjappa, MD · Answer

Thank you for your question and the photo. It is possible that the frontalis muscle in your case appears very strong after treating Glabellar lines and therefore you may need more units in the forehead. It is also possible that there is an an issue with that specific batch of Botox which was used for you. Some people are truly resistant to Botox and even Dysport treatment. Speak with your injector and find out the total number of units you have received so far, and compare your before and after photos. If you are still not satisfied seek another expert opinion.

Best of luck

Dr. Shanthala

Best of luck

Dr. Shanthala

Andrew Campbell, MD · Answer

Sorry to hear about your problems. Botox works and it works well and consistently. I'm not sure what the problem is, but if you have muscle motion, Botox should easily be able to treat it. I'd recommend you see an experienced injector (someone else).Andrew Campbell, M.D.

Facial Rejuvenation Specialist

Quintessa Aesthetic Centers

Facial Rejuvenation Specialist

Quintessa Aesthetic Centers

Jeffrey S. Rosenthal, MD · Answer

Generally, Botox is a wonderful product that is used to balance the forehead overactive  muscles.  The position of the eyebrows, quality of the skin and the activity of the muscles on both sides of the forehead should be evaluated to determine the proper amount and placement of Botox.  The object is the softens the wrinkles, reposition low lying eyebrows and create a rested appearance. Excessive motion after a treatment may be attended to with small amounts of additional Botox to calm down expression wrinkles.  However, the overall appearance of the forehead and brows when actively raising them and their appearance at rest should be evaluated both before the administration of Botox and after it has fully taken effect. Only then should additional Botox be placed.  There are many variable that go into the artistic injection of Botox.  The amount used, the placement of the Botox and what the overall objective is are all important.

Richard W. Westreich, MD · Answer

Like anything else involving people, variation in sensitivity and effect are likely. People are genetically diverse and, just like fingerprints, no 2 people are exact matches besides twins. This goes for receptors too. Botox may not work on you. I have a few patients in which this is the case. I also have a few patients where it only works for 4-6 weeks. I have tried dysport and xeomin to see if that worked better in some of those patients but it made no difference. You should try these other products and see if they work better.

Hardik Soni, MD · Answer

Thank you for your question. This is rare, but can happen in some individuals. There are alternatives for people who tend to metabolize Botox faster. These alternatives are Xeomin and Dysport. I recommend having a consultation with your injector to determine the best treatment plan for you.

Jeremy B. White, MD · Answer

You still have forehead wrinkles, so I understand your frustration! It is possible that, despite your touch ups of extra Botox (assuming appropriate dosing), Botox was either not injected high enough in the forehead or, very rarely, you might have an actual resistance to the medication. Perhaps you should try Xeomin or Dysport and see if you get a different result?

Steven Wallach, MD · Answer

It is hard to say whether or not the injections were placed properly, or the dose was off, or what.   But a good effect should occur within a week or so after injection.

Jack Berdy, MD · Answer

At first glance of the picture it appears that you were not given a high enough dose. At 6 weeks out from the initial procedure you are about half way through the expected duration of the Botox affect. The wrinkles secondary to movement in the picture can result from too low of a dose initially, inappropriate placement, or resistance (albeit rare). I suggest you go back to your injector and find out the dose (in units) you have received. If you have received 30-40 units in your forehead and have no improvement 10 days later then you might want to consider another opinion or try one of the competitive products such as Dysport or Xeomin. I hope you next treatment yields a more satisfying result. Good luck

Dr. Berdy

Dr. Berdy

I don't think I was given enough botox. (photo)

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