I Think my Botox Injections Didn't Work, Is This Possible?

On Friday, I got 38 units injected into my forehead, crows feet, and area between my eyebrows. It's been over 72 hours and I see no effects. I've had Botox 2 times before. The 1st time I got 45 units and the 2nd time I got 30 units... which I felt was more natural. This time I went to a different doctor (I moved) and she gave me 40 units. I called her and she said to come in on Friday and she'll reinject me, as much as needed. But I'm scared! Why didn't it work?? Can I get 80 units and be OK??

Doctor Answers 7

Botox Injections

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Please wait at least two weeks before assessing whether or not your Botox treatment has worked.  38 units to cover the three areas you described is not a lot of material.  It is possible that you will need more, but please wait the two weeks before making that decision.

Beverly Hills Dermatologist

Can Botox "not work?"

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I would not recommend getting more Botox until you have waited a full 2 weeks. After 2 weeks, return to your doctor for re-evaluation. Very occasionally, we have people complain that it "didn't work"--sometimes we notice it was from the same lot number. Usually when I see patients who complain that it "didn't work," it has worked; either they just need a touch-up, or they weren't looking at the right area on their face. It is safe to get 80 units, but you may not need that much.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 42 reviews

Botox didn't seem to work

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Botox is an extremely common treatment in the United States with roughly 5,300,000 procedures performed in 2010 according to the ASPS. Every injector probably administers the medication a little differently. For moderate to severe frown lines, I typically start with 20 units total and make five separate injections each with 4 units.  I prefer to use 16 units for forehead lines, and another 16 units for the crow's feet.  It usually takes a day for the medication to start working and one week for it to have its final effect.  I always try to take photos prior to the treatment, and I see patients back at two weeks to make sure the results are desirable.  If it gets to be a week, are you are still not happy, you should certainly discuss your concerns with your plastic surgeon.

Kelly Gallego, MD, FACS
Yuba City Plastic Surgeon

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Wait 2 weeks before assessing results

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It can take up to 2 weeks for results to appear. If by two weeks you still aren't satisfied with your results, please return to your injector.  

Botox Injections Didn't Work

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It will take another week to ten days to determine the maximum benefit of the treatment. The efficacy of botox can be impacted by the technique, storage, and dilution of the product.  Therefore, 40 units in experienced and expert hands will go further than 40 units in inexperienced hands. If you wait for the two weeks, it would be safe to get additional units when you return.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Wait more before having Botox reinjected

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Botox can take up to two weeks, and even more to have the peak onset of effectiveness.  If you get more Botox injected before the peak effect occurs, then you may have more of a relaxation effect than you wish.  A reasonable wait is between one and two weeks, and unless a patient is very asymmetric, and needs an urgent readjustment, I prefer to have patients wait two weeks. Of course some patients need more units than others. Other variables are if the Botox was diluted a while ago and lost some potency, or if another product is used or if it is injected into different anatomic sites.  Botox uses a physician's scientific and aritistic sense.  Hopefully you'll see more improvement as you wait for a few more days.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Botox did not seem to work

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Botox can take 2 to 10 days to work. I would not get any more injections without waiting 10 to 14 days. I usually use 20 units in the frown crease, 20 units for the forehead and 24 units for the crows feet.. So you definitely did not get a lot of units if you had all 3 areas injected. Another thing to ask is do they save their Botox? If so ...how old was the bottle? Botox is it's most potent if mixed the day you receive the injetions.

Esta Kronberg, MD
Houston Dermatologic Surgeon
4.9 out of 5 stars 28 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.