I’ve have Botox a couple times at two different places and have gotten no results? (Photo)

Additional Botox or a combination of filler/Botox may be needed to improve this area. It takes 1-2 weeks for final results. Hope this helps.

Botox can be used to improve wrinkles. However, deeper wrinkles need a combination approach with Botox and lasers, microneedling/prp and fillers. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Perhaps you are resistant to Botox? You may want to try Dysport instead.The foregoing information provided is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition.

Botox stops muscle movement but does not replace lost volume.  You should consider a combination of Botox and a filler such as Restylane, Juvederm or Belotero for best results.

Thank you for your question and for sharing your photograph Clight. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without knowing the dose used and placement of the product. However, I hope the information provided here is useful.The appearance of frown lines is variable from person to person. Usually they are in a vertical orientation but sometimes they can be oblique and sometimes a horizontal line is seen across the upper portion of the nasal bridge. The most common variation is to have two parallel lines, hence the common term "11's" to describe them. But some people have one, three, or more lines. Some people also will see a bulge in the area when contracting the muscle. This bulge is smoothened out after a Botox treatment.The pivotal studies used 20 units of Botox in the glabella area between the brow to address the frown lines. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary.If I had a patient who did not get results after a treatment from another clinic I would recommend that she return to that clinic to address it because they are the ones who know how much product was used and where it was placed.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids as described above. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.Please consult with a doctor for specific recommendations. Good luck!

It is possible that the Botox is not working since your may need fillers on top of Botox.  It is also possible that you may be immune to Botox and you may need to try Dysport or Xeomin.  Please consult an expert in Botox and cosmetic injections for the best results.  Best, Dr. Green

A couple of things are happening with your Botox treatment.First, you will need filler carefully placed in addition to your Botox. You have a fixed crease that will need some filler.This may need to be done over several treatments. You have to use small amounts at a time.If you still have movement you need a higher dose of Botox.You may try changing to Dysport or Xeonin (the other brands).Discuss this with your injector.Let them know it is not working. Give it 2 weeks then return to your injector.And lastly, I find fresh Botox mixed that day is the most effective. You may want to ask how long they keep their Botox after mixed.Don't give up yet. It is extremely rare for it not to work.Sometimes it actually is working and you don't realize you need to add the filler.Good luck to you.

Botox, Xeomin and Dysport are neurotoxin products that work to RELAX MUSCLES that are under the skin.  They do not act directly on the skin.  Skin cell turnover in adults is about every 6-8 weeks.  When skin cells reproduce and turnover while the underlying muscle frequently contracts, the skin comforms with a crease, furrow or wrinkle that is present in the skin even when you are not contracting that muscle.  If you get Botox (or Xeomin or Dysport) frequently enough---say every 3-3-1/2 months---for 3 or 4 consecutive treatments, you will have gone through enough skin cell turnovers (under conditions of relaxed underlying muscles) that those wrinkles and lines should be gone or nearly-gone.  Again, the neurotoxins treat the muscle; not the skin.  

I hope that helps!
Deborah Kessler Hudak, MD, MHA,  Oculofacial Surgeon, All About Aesthetics, PC, Raleigh, NC  27615

You have reached a point in life where something more surgical has to be performed on your face to see marked improvement and Botox is not one of them. I would recommend scheduling a consultation with a plastic surgeon like myself. Good luck from New York City

Hi Clight,Botox works best on dynamic wrinkles - meaning the wrinkles you make while you smile, squint, from etc. I hope that has improved somewhat.However, the wrinkles, specially in the glabella area seem to be passive and exist even at rest. These would need fillers and in some cases lasers or deeper peels.All the best, Justin Harper, M.D.