Botox failure, again! (photo)

I'm experiencing Botox failure in my 11's. After having 40+ units put into my 11's (I'm only 34 and have a very slight line), my Botox disappears overnight about a month after treatment. I can fully contract that muscle, same as before treatment. The injections were all performed by three different board certified doctors with 20+ years experience so undertreatment and poor application are not an explanation. Nor is it likely that three diff bd certified doctors carry expired product. Solutions?

Doctor Answers 17

Botox Failure, Try Dysport or Xeomin for “11” Wrinkles

Sorry for the frustrating outcome. You may have a resistance to Botox. You can try another neuromodulator, like Dysport or Xeomin. Please see an expert. Best, Dr. Emer


Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 167 reviews

Botox Failure

Everyone does metabolize Botox differently. I would recommend  a neuromodulator, like Dysport or Xeomin. Best of luck. Please consult a professional in your area.

Botox failure, again!

Thank you for sharing your experience and I am sorry to hear of your failed Botox results.  At this point I would recommend trying one of the other neuromodulators for effects - Dysport or Xeomin.  Some patients have increased resistance to Botox that can then receive nice results with one of the other medications.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Botox not working

Thank you for your question.  In my experience, very rarely patients metabolize Botox faster then normal.  I would suggest trying Xeomin or Dysport.  Sometimes this works. Good luck.

Lack of Improvement from Botox

I will often offer my patient to do filler in the area of the 11's as this seems to enhance the effects of the botox especially if the botox does not appear to last long enough or give enough improvement. Ask your physician about that option as it is very effective. You may also consider a different neurotoxin such as dysport or Xeomin but this may not be any more effective. Good luck in your area.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Botox effects

Thank you for your question TinyLip. I am sorry to hear about your situation. Botox is a purified protein used to address wrinkles associated with facial expression. For some people Botox stops working after a certain time. This is rare and the reason for it is not understood. For these people alternative neuromodulators such as Dysport and Xeomin can be tried. Please consult with a doctor for specific recommendations.  Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 1 review

Botox Only Lasts 1 Month

If your Botox is not lasting up to three months, culprits other than poor injection or expired product, which you ruled out, may be that you may have antibodies to the Botox. A solution would be to try a different type of botulinum toxin. If that does not work, you may just be the type who metabolizes this product fast.  Unfortunately, there's not much to do if that is the case. Botox injections more frequent than every three months is not recommended, nor should it be done.

Millicent Odunze-Geers, MD, MPH
Sacramento Physician
4.6 out of 5 stars 5 reviews

Botox Longevity

Considering you get a great result initially, I doubt it's antibodies to the Botox. More than likely, you have some lateral corrugator muscle that the initial treatment barely treats. That portion of the muscle then starts to work after a month and it looks like your Botox wore off overnight. I'd have to actually examine your muscle motion to be certain, but that could explain your problem. Adding a little Botox a little more laterally may cure the situation. On the other hand, trying Xeomin or Dysport (Dysport has different proteins than Botox so you wouldn't have antibodies to both) isn't a bad idea just to see if that helps. Realize that all three have the same active molecule, just different (or no) additional proteins surrounding them.Andrew Campbell, M.D.Facial Plastic SpecialistQuintessa Aesthetic Centers

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Poor longevity of Botox

This happens in a rare case. I would try using Xeomin. It's possible you have antibodies to the Botox. If Xeomin doesn't give you improved duration, you are just a rapid metabolizer and nothing else can be done.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Botox failure, again!

I am sorry to hear of your concerns about your Botox. there are a handful of people that Botox does not seem to last the average 3 months on. This is due to your body metabolizing the proteins in Botox faster than normal. Try a different brand such as Dysport next visit and see if it makes a difference. 

Lawrence Bundrick, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 6 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.