Botox doesn't seem to work for me? (Photos)

Question

I received Botox for the first time 3.5 wks ago. Was given 22 units between my eyebrows. After 2 weeks I had 90% mobility back in that area. Went back and got 14 more units. Noticed a difference for the first 3 days but now it's wearing off again. Why would this be? Am I immune? I'm a trainer and I work out rather intensively 5-6 days a week. Would that be a factor? Is there another product or procedure I should try or was it the technique used to inject was wrong?

Michael A. Zadeh, MD, FACS · Answer

There are a couple of reasons why Botox may not have worked for you. If your injector is not experienced then he/she may not have injected you correctly into the muscle. Very few people are actually "immune" or resistant to Botox. I would try a different injector. If it still doesn't work for you then you can try a Botox alternative such as Dysport or Xeomin. Just remember, though, you have deep lines at rest and those lines may not completely go away with Botox. Hope this helps!

Hardik Soni, MD · Answer

I am sorry to hear about your situation. It is very unusual for someone to not respond to Botox. Some patients due require more Botox then others. It could be possible that the injector’s technique was not good. Please make sure your injector is an expert. In addition, you may want to consider an alternative such as Dysport. It is highly unusual for Botox not to work.

Andrei Metelitsa, MD, FRCPC, FAAD · Answer

There are a variety of features that determine botox effectiveness including total dosing, reconstitution (how botox is mixed), injection placement, type of botox used (botox vs dysport vs yeoman) etc. Although physically active people tend to wear off botox sooner they still typically should get 2.5-3 months duration so 2 weeks is rather unusual. I recommend that you seek another expert injector to determine why your botox has not worked in the past. Alternatively, switching Botox preparation to another brand, for example Dysport could lengthen the overall duration of your result. Alternatively, your lines could also be corrected with injectable filler, for example restylane or emervel. Only expert injector should inject glabella as there are many blood vessels in that area and improper injection can lead to permanent adverse effects.

Nicole Hayre, MD · Answer

It is very rare for someone not to respond to Botox.  On occasion patients do require more than average to have a good effect.  It is also possible that the injector's technique was not ideal, so make sure you are seeing an expert.  If it is an expert, he/she will be able to figure this out for you and get the results you are looking for.  Good luck!

Michele S. Green, MD · Answer

I would return to your treating physician for examination since it sounds like you had a sufficient amount of Botox to have this area "frozen".  For the best cosmetic results please consult a board certified dermatologist.  Best, Dr. Green

Botox doesn't seem to work for me? (Photos)

Answers (8)