Botox Wears off in One Month, Should I Try Dysport?

Question

ive been injected by botox type 3 time already, but in less than 1 month my forehead lines are back, what do i do, which brand shall i choose now that will last the said period of 3-4months?

Young R. Cho, MD, PhD · Answer

Thank you for your question and concern. I train a lot of injectors in the proper technique for Botox injections. Here are some of the common reasons that Botox wears off too quickly:1)  Inadequate dose - higher doses usually corrects the problem2)  Cookie cutter approach to injecting Botox.  The same technique is used for every patient and it works for most, but not all patients.  The cookie cutter approach fails to appreciate the differences in anatomy of the facial muscles that can vary by the individual.3)  Rarely, there are patients who truly have shorter durations with Botox and may want to consider the different neuromodulators available to see if there is a difference. I would recommend that you go an experienced board certified plastic surgeon or dermatologist who does a high volume of injectables to discuss your experience in more detail.

Harold J. Kaplan, MD · Answer

If your Botox is working when initially injected and then ceases to work after one month, you should probably look for another injector. Either you are not getting real Botox or you are getting too much solution (saline solution that Botox is mixed with) and not enough actual Botox itself. In either case, you may want to search for another injector. Good luck.

Ron Shelton, MD · Answer

your problem of short acting botox may be a result of not enough units of botox from a conservative physician. It might be worth a visit to a different board certified dermatologist or plastic surgeon

Kevin M. Robertson, MD, FACS · Answer

All of us that have a lot of botox patients will run into cases like yours.  I also agree with what others have posted.  One, make sure you have a trial with enough med, that is recently reconstituted and placed correctly.  If that failed, then consider dysport.  It is possible to respond to dysport where your prior history with botox cosmetic was suboptimal.  In general, given equivalent dosing schedules, we have had more failures with dysport than botox, but each case is different.

	Most of my patients that don't get a normal duration from botox are fast metabolizers. Runners, personal trainers, or just personalities that are constantly on the move.  Something to consider for a reason in your case.

	Later this year additional competition will also hit the market, including puretox and other companies version of botulinum toxin.  Keep your ears open for this if dysport is too short too.

David Hansen, MD · Answer

Sometimes you may not be getting enough botox into the areas if it wears off in only 1 month. If you are not spending at least $300 for the forehead then you are getting too little Botox. Try Dysport or have your doc use more units of botox. Dysport is replacing Botox in many offices.

Steven J. Pearlman, MD, FACS · Answer

I have found that one third of patients like Dysport better than Botox stating that it worked faster and lasted longer. one third of patients treated with Dysport saw no difference and one third didn't like the results stating that there was "too much" loss of motion and/or headaches. So, each individual reacts differently.

Otto Joseph Placik, MD · Answer

I would try Dysport and assess if it provides you with any long term chemodenervation. In some individuals Dysport seems to act longer.

Joseph A. Eviatar, MD, FACS · Answer

BOTOX should not wear off in one month. You may not be getting the right dosage. Be sure to choose a physician who is experienced in BOTOX. According to the FDA insert, Dysport lasts for a similar amount of time as BOTOX. However, some patients do report that their results have lasted longer with Dysport and are happier with this alternative toxin. Dysport is always worth trying.

Marisa Lawrence, MD · Answer

Botox should last 3-4 months if diluted properly and administered properly. Most patients who are not satisfied with Botox usually need more units injected. I have had some patients who have had Botox for a long time and are not getting the same results after many years of treatment. In these patients dysport has worked great.

Peter A. Aldea, MD · Answer

When fresh, non-dilute, genuine (not fake or gray market) Botox is administered by a Plastic surgeons who knows what he is doing, the effect lasts 3-6 months. It is unheard of for Botox to last 1 month.

	Every time I saw patoents with the repeated complaint :"Botox does not work on me...", they were  getting their "Botox" from a bargain injector, probably not even an MD, much less a Plastic Surgeon who injected them with either dilute, old, gray market or fake Botox with predictable ineffective consequences.

	To read THE Most Comprehensive page on BOTOX on the Internet, go to the link below - 

	Dr. P. Aldea

Botox Wears off in One Month, Should I Try Dysport?

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