Failed Botox. Why would this happen? (Photo)

Question

I have had 58 units of Botox in my forehead, my 11’s and above my eyebrows due to previous Botox results left me with the “Spock”. I am four weeks out and still have full movement. I have gone back one already after originally having 32. They did additional 26 and still no change. Why would this happen?

Eric M. Joseph, MD · Answer

58units of Botox should be enough to make your forehead completely immobile, like an ice skating rink, but there are several factors to consider. Some people do not get a full effect after repeated treatments, and trying another brand of neuromodulator may be considered. It's possible your injector didn't target your high forehead muscles to allow you to keep the ability to elevate your brow. You appear to have a response in your lower forehead. Occasionally a batch or bottle of Botox can be weak. Touching up your forehead should be straightforward, so consider revisiting your doctor. Good luck! Dr Joseph.

Jason Emer, MD · Answer

Botox can be used to improve forehead wrinkles. 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

Jonathan Kulbersh, MD · Answer

It's difficult to say. This may be due to placement. Keep in mind, it can take up to 2 weeks for final results with Botox. Deeper wrinkles need a combination with fillers. Hope this helps.

Monika Soni, MD · Answer

Botox can be used to improve forehead wrinkles. Deeper wrinkles need a combination approach with Botox and lasers, microneedling/prp and fillers. I recommend getting a formal evaluation with a cosmetic dermatologist.

Carmen A. Traywick, MD, FAAD · Answer

Hello Candyann521 - Sorry that you are having this issue. Based on the photos that you have provided it appears that you may need additional units for correction. 
Botox, Dysport, and Xeomin lock the release of a chemical called acetylcholine, which triggers the muscle contractions that create wrinkles. Botox, Dysport, and Xeomin essentially paralyze the muscles and stops them from contracting. Results from these treatments are visible within two to four days with results that can last anywhere from four to six months.
It is best that you follow up with you injector to discuss your options and goals. You can also see a board certified dermatologist or plastic surgeon. Best wishes.

Michael H. Gold, MD · Answer

Thanks for your question and the photo and sorry that you are having these concerns after your injections. We always recommend that you have these performed in the offices of board certified dermatologists or plastic surgeons. We are the experts in using these technologies.  It appears you had one adverse event first, had more toxin placed and still are having issues.  It may be that more time is needed – that would be good or you are being injected by someone not that skilled in using Botox. Find the right provider and get things done right.

Marek Kacki, MD · Answer

Overall, you have received rather "industrial" dose of Botox. The photo is not of good quality to be sure but it appears that in some areas the effect is visible (lower forehead). Although possible, the resistance to Botox is quite unusual in general population. I would definitely question the amount you have received! I suggest to ask another injector to add Botox  in the upper forehead close to the midline. If results are good, you should absolutely re-visit your first injector's fees! Good luck!

Melvin Elson, MD · Answer

There are a number of reasons that you may not have gotten results. the Botox may have been mixed long ago or dilution is incorrect.  the doctor may not be experienced in the use of the material. this amount of Botox and amount of time since injection should give good results and no combination should be needed. see a board certified experienced dermatologist

Alison Abiri, MD · Answer

The Botox is injected in the wrong locations.  If the botox is not placed in the correct area, it may not reach the neuromuscular junction of the area you want to improve.The Botox was not prepared or stored correctly.  Botox must be reconstituted prior to use.  Errors in reconstitution can result in sub-optimal  resultsThe lines you want to decrease are not lines cause by active movement of the muscles typically treated with Botox.  You maybe trying to treat lines that are lines at rest.  Botox tends to only work for those lines that get worse with movement.The lines are too deep for instant results.  You may have lines are a result of skin damage due to repetitive creasing.  Don't despair, after consistent injections (every 4 months) over 6 months to a year, these lines should gradually improve and potentially disappear as your skin heals.  If you just hate the line and want fast results, consider combining Botox with Fillers and skin treatments such as microneedling with or without PRP (platelet rich plasma)

Andy Shieh, DMD · Answer

It looks like your injector did not cover all and didn't go lateral enough on your frontalis muscles.  This is an easy fix in the experienced injector's hands.

Failed Botox. Why would this happen? (Photo)

Answers (14)

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