Can I Be Resistant to Botox and Other Fillers?

Since my last question I have 35 units of Xeomin to my Galbella and forehead, it worked worderfully and alsmost immediately, however 1 month later and it is already starying to wear off?

Doctor Answers 15

Xeomin wearing off

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Xeomin working to the desired effect shows that it was effective. In some cases, more units may be needed to achieve a longer-lasting result. In other cases, the expected 3-4 month duration is simply shorter in some patients than others. Some patients needs to get re-dosed every 2 months or so in order to maintain their results.

All the best,

Frisco Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews


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It sounds like you may need more units to get the desired result that you want. I would recommend following up with your provider.


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Some people require more units then others. Since you did have a response, it shows that the Xeomin did work. It is not common to be resistant to Xeomin, Botox, or Dysport, although it is possible. 
Usually Xeomin lasts for three months, since yours is wearing off so soon, you may need additional units to recieve the full effect. 

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Xeomin wearing off in 1 month

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I am not sure why your Xeomin injection is wearing off after 1 month.  In my patients it lasts 3 months (similar to Botox).  

Reasons may be related to the material.  It may have been near the expiration date or mixed more than a month before it was injected.

If you really had a full, complete response, you probably received enough medication and I do not think the amount injected is the reason.

Consider getting a touch-up with a new, freshly mixed bottle and see if the response lasts longer.

Harry Goldin, MD
Skokie Dermatologist

Can I Be Resistant to Botox and Other Fillers?

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Some people simply require more of the product to achieve a long-lasting effect. Because the product is a neurotoxin, it is generally not possible to be completely resistant to it, and the fact that you did have a response shows that it does work. In order to have your results last for the advertised 3-4 months you may simply need more toxin injected with each treatment. Best of luck!

Mathew A. Plant, MD, FRCSC
Toronto Plastic Surgeon
4.9 out of 5 stars 39 reviews

Resistant to Botox

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Sometimes you need to have more toxins injected which we don’t always want, but is reality when you do this enough times. For clarity, Xeomin is a neurotoxin, like Botox and Dysport; fillers are Restylane, Juvéderm, and Belotero, among others.

We know from having done this now for a long time that sometimes more toxin is needed in one set of injections than we used previously. This may be due to a lot of things, but no one has adequately described this so know that this can happen. In most everyone out there, the toxins all last about the same amount of time, anywhere from 4-6 months. That does mean sometimes it will last less, and that sometimes it will last more.

Consult with a board-certified dermatologist or plastic surgeon for the best results.

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Can I Be Resistant to Botox and Other Fillers?

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You may need more units applied to the area. Xeomin that was injected may have soften the lines but if you have strong muscle movement, it would not have provided full correction to have fully paralyzed the muscle. 

Best of luck 

Resistant to Botox and Other Fillers? #Xeomin

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Xeomin, which you had injected, is a neuromodulator similar to Botox an Dysport.  Fillers include Radiesse, Restylane, Perlane, Juvederm and Belotero (those are the most common ones).  Both fillers and neuromodulators are referred to as "Injectables."

Anything is possible but I wouldn't assume that you're resistant to Xeomin just yet.  Are you sure it was 35 units?  Do you know how fresh the solution was, or if it was reconstituted correctly?  Xeomin requires more time and/or shaking to be reconstituted as the product is often stuck underneath the cap, resulting in a weaker concentration that one might assume.

Resistant?  Possible, but not likely and, either way, too early to say.

I hope that this helps and good luck,

Dr. e

Xeomin and Botox neurotoxins work well

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In our office, we have found Xeomin to be long lasting in patients as compared to Botox injectable neurotoxin.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Resistant to Botox?

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  You can develop antibodies to Botox.  This is far less common with Xeomin which makes it a superior product.  Botox and Xeomin are not fillers.  It is possible that your Xeomin dose needs to be tweaked for best effect.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.9 out of 5 stars 137 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.