Dysport injected, not satisfied with results. Why do I still have lines present? (Photo)

Question

Had dysport injected for gabellar lines. First week was good, second week went back and said I'm not satisfied I still have lines. She told me that was normal some times you have good results some times bad results it will always be different. I paid a small fortune for this and I'm not happy my lines should be gone. She injected another small amount don't think much at all no change. Told me to comeback back in 4 months. Did I miss something here?

Jason Emer, MD · Answer

Deeper lines need a combination approach with Dysport combined with fillers, lasers, and microneedling/prp. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Alexander Rivkin, MD · Answer

Thank you for your question and sharing your photo. I am sorry you are unsatisifed with your Dysport result. Dysport can take 3-5 days to start taking effect, in which you will notice some restricted movement to the muscles that were injected. It can take up to 2 weeks to see the final results. At that point, if you still have undesired movement to the muscles injected, you can revisit your injector to have additional units placed. It will again take up to 2 weeks to see the final effects of the Dysport. Unfortunately, Dysport will not treat lines that are already etched in. From your photograph, it appears that you may need another 6 units to the procerus and 12 units to the corregators (18 units total, or the equivalent of 6 Botox units) to have complete restriction of the frown muscles. Each person has a different aesthetic goal when it comes to Dysport. Some want to continue to have muscle movement so they can continue to make expressions but not as forcefully, whereas some want to have no movement at all. Always be sure to communicate your goal to your injector. Seeing that you have already had a touch-up visit with your injector, I would advise to wait until 2 weeks to see the final outcome. You can always add more if needed! Dysport should last you 3-4 months. Please let me know if you have any more questions!

　

Paul S. Nassif, MD · Answer

Hello and thank you for your question, Neurotoxins react differently for each patient, including the amount of product needed and time needed between touch ups. I suggest speaking with your board certified injectionist about the options for other treatments that may be better suited for your needs. I hope this helps to answer your question and I wish you the best of luck.

Omar Lazos, MD · Answer

Thank you very much for one of the most common questions/complains after botulinum toxin A application. The glabella muscles are strong small structures that to paralyze completely need different doses individualized in each patient. Factors that modify the dosing of the muscles are gender, muscle strength, if there's already lines and how much the are marked. So as simple as applying a higher dose next time can solve this issue... Its just that some patients require higher doses than other according to the musculature strength... Thank you .

Peter N. Butler, MD, FACS · Answer

It seems as though you needed a higher dose. She knew this as well, which is why she added additional product. Has it been at least one week since your touch up? The added Dysport needs time to work, just as your first treatment did. If you still do not get the desired result, you may need an even higher dose at your next treatment, or a second in-person opinion.

Philip K. Robb Jr., MD, FACS · Answer

Thanks for your question. Some people have stronger facial muscles and require a bit more treatment. For example, I require a good bit more than my wife in my glabella area to achieve the same effect. Some people are concerned with antibiodies that render the medication non-function. This is extremely rare and doesn't appear to be happening.  You may need a smidge more dysport to get you the look you want.. 
Hope this helps and God Bless!
Dr. Robb

Aldo Guerra, MD · Answer

Your injector is right in a way. Not all parts of the lines go away with Dysport or Botox. You should consider chemical peels, microneedling, and lasers to soften your wrinkles even more. Best wishes, Dr. Aldo

Monika Soni, MD · Answer

Thank you for your question. It can take up 7 days to see the effects of Botox and up 2 weeks to see your final results. Follow up with your injector after 2 weeks, if you see no change as you may require a touch up. Best of Luck

Summit Kundaria, MD · Answer

Thank you for the question and pictures.   Guiding you would mean knowing how many units were injected.  Assuming that "enough" was injected, what we may be looking at instead of the muscle's mass is soft tissue indentations due to the muscle action, or "etched lines".  Once you have as much flattening in this area as you can get with paralysis of the corrugator and procerus muscles, then sometimes a little filler to augment the soft tissue can bring the area out with a more pleasing contour.  Good luck!

Benjamin J. Cousins, MD · Answer

Thank you for your post. You may require more Dysport than originally placed or the addition of fillers to fill in the lines and creases. Dysport will typically begin to "kick in" after 4-7 days, but some may see results earlier. The full effect is usually seen after 7-10 days so two weeks after your injections is a great time for a follow-up with your injector if you are not getting the results you desire. Dysport and Botox typically last around ~ 3 months, and after that it begins to slowly wear off. 
Dr. Benjamin J. Cousins MD Board Certified Plastic Surgeon Miami/Miami Beach