Botox and Dysport used to work on me. Now however I have become immune to both of them. Will this immunity be forever?

Dear miamigrl1111,Rather than waiting you would be better served using a different neuromodulator, such as Xeomin or Juveau. There is no guarantee that waiting will reduce your immunity over time.Good luck,Nirmal R. Nathan, M.D.

·      Certified, American Board of Plastic Surgery

·      Member, American Society of Plastic Surgeons

·      RealSelf Top Doctor

I have been injecting Botox since 1991 and Dysport for over fifteen years. And while it is commonly maintained that the development of true immunity from their use is rare, in my long career and very extensive experience, I have encountered this on a number of occasions. Happily, in my cases, I have been able to override this relative resistance by increasing the concentration of the injection of the injected neuromodulators. Where this has not been successful, I have switched to injecting Xeomin, which is essentially Botox with many of the surrounding protein molecules (the ones most believed to actually be responsible for promoting resistance) stripped away. In most cases, this approach has proven successful. If not, an alternative non-neuromodulator approach, is to inject hyaluronic acid-based skin boosters, such as Restylane Silk (in the U.S.) or Viscoderm Hydroboosters, Restylane Skinboosters or Juvederm Volite (Israel, Canada, Europe) throughout the treatment area (such as the crow's feet, worry lines, bar code lines, etc.). Instead of working directly on the muscles themselves, like Botox, skin boosters, via increased hydration within the skin and stretching of the overlying skin, elevates and smooths the skin and to some extent resist wrinkling upon motion. Make sure to consult with a board certified aesthetic physician. Best of luck to you.