Been back twice and Botox still not worked on me?

I am 26 and have had Botox in my forehead twice in the last 2 years. I went back to have it done about 2 months ago and needed to go back in for a top up 2 weeks after because it only seemed to work around the hairline but made weird wrinkles when I raised my eyebrows, 2 weeks later that still hasn't done anything! I went back again and he tried a different type of Botox (think it was Dysport) and it's been 10 days and still absolutely no difference. What do you think I should do?

Doctor Answers 15

BOTOX® Cosmetic

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Hi tjr_x,

I think you should get another opinion and do your research on the physician before booking the appointment. From the experience you described, it seems that you needed a little correction at your follow-up visit and that the correction did not do the job. Please keep in mind that what influences your result is the amount of BOTOX injected and the technique used by the injector (the precise location of each site being injected). I would like to add that for optimal results, you should have more regular treatments because if you wait until the effect completely wears off (something that happens within 3 1/2 - 41/2 months typically) than it is as though you are starting from scratch each time. This will result in the dynamic wrinkles you see when raising your eyebrows eventually becoming static wrinkles (visible even without movement or "at rest" as we say). I hope this helps! Best, Manish Khanna, MD

Montreal Dermatologic Surgeon
4.7 out of 5 stars 25 reviews

Botox Not Working

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I recommend you trying a different injector. You may have improvement with a change of dose and placement of Botox/Dysport. Best of Luck!

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

Know Your Injector

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Thank you for your question.  You are so wise to start treatment with Botox and/or Dysport, both of which are termed “neuromodulators” or muscle relaxers, while at your young age as prevention.  Due to the fact that Botox and Dysport are both neuromodulators, their mechanisms of action are very similar so you most likely would not see a difference in your results. From the situation you described, it sounds like you either did not receive the adequate amount of neuromodulator and/or the technique of injection was not right for you.  Because every person requires unique placement of product due to their unique anatomy, it is best to consult with a board certified dermatologist or plastic surgeon who has extensive training and experience with injecting.  They will not only know how much neuromodulator is appropriate for you, they will also know the correct way to inject for optimal results. Also keep in mind that treatment with neuromodulators requires maintenance so it is best to follow-up with your physician every 3 – 4 months.

Kristine Romine, MD
Phoenix Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

Botox not working

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Botox results can take two weeks to settle.  The most important factor with longevity and botox is proper dosing.  Ensure you see a board certified plastic surgeon or derm.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 508 reviews


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Sounds as if you were under treated.  The neurotoxins work and are supposed to be used on a schedule.You can find a member of ASAPS or ISAPS in your area for a Plastic Surgery opinion.

Botox Works with the Right Injector

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Dear tjr_x:

Thank you for your question.  Botox works effectively to soften up wrinkles and lines.  My recommendation is to see an expert injector for best results.  All the best.

Dosage of Botox and other Botulinum

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Botox and other Botulinum toxin are proven to be effective and yield result. It can very well be that you are being under-treated and not getting enough units injected in the appropriate area to get the result you want.  Usually it takes up to 2 weeks for maximum result.

You can always seek another physician with knowledge and experience.

Something to keep in mind is whether a doctor is performing the procedure or someone under them?

David P. Melamed, MD
Los Angeles Dermatologist

Alternatives to Botox--Xeomin and Dysport

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This is tough to answer without before and after photos. Sometimes it requires more units in some people. Sometimes fillers are needed as well.  I suggest seeing a cosmetic dermatologist with experience in neurotoxins and fillers.  Also, dysport or xeomin are alternatives. See an expert. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 204 reviews

Been back twice and Botox still not worked on me?

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Hell tjr_x,

The main reason you don't see the result you want with Botox or Dysport is either under dosing or improper injection location.  They are both amazing drugs when used correctly to help with the lines that develop with activity.  I'd recommend you consult with a physician injector from one of the core aesthetic fields (facial plastic surgery, plastic surgery, dermatology) to get a second opinion and another injection. 

I hope this helps and good luck. 

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

Botox not Working

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Thank you for your question.  I am sorry that you are having this experience with Botox and Dysport.  I would suggest you seek a second opinion with a board certified facial plastic or plastic surgeon who specializes in the face and has experience with neuromodulator (Botox and Dysport) injections.  You may see an improvement with a change in the dose and/or placement of the injections.  I always see my patients back in clinic in 2 weeks, to assure that the injection has achieved their goals.

I hope that this helps!

-David Gilpin 

David Gilpin, MD
Nashville Facial Plastic Surgeon
5.0 out of 5 stars 24 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.