Resistant to Botox, Dysport and Xeomin. Any suggestions?

Question

i've been getting Botox, Dysport and Xeomin in the past seven years to reduce the size of masseter (so the lower face looks slimmer), however in the past two years it is not working any more. I realized I might be resistant to Botulinum toxin type A. I wanted to try Type B (i.e. Myobloc) but having a hard time finding a doctor that provides Myobloc cause it is less commonly used. I live in Seattle, WA but I am willing to travel.

Caner Kacmaz, MD · Answer

Botox resistance is very rare. It's estimated that 1 patient out of 10000 develops Botox resistance. The most common reason that Botox does not work is that not enough dose was administered. The same dosage does not work for every patient. Some patients may need additional dosage to reach an effective level of muscle weakness. In some cases, Botox that was used on a patient can be overdiluted or even old. You should always have a follow-up appointment 7 to 10 days after your initial treatment so your doctor can see the results and apply more if needed to correct the problem areas. Good luck.

Jason Emer, MD · Answer

If Botox is not an option for you, Dysport or Xeomin are the next options. I suggest dermarolling at home to give the skin Botox-like effects with at-home treatment. See an expert. Best, Dr. Emer

Alan Gonzalez, MD, FACS · Answer

Hello @qmbritain, thank you for your question. It is important to take into account that some organisms develop resistance to botox, causing the effect to be minimal and short-lived. For this reason, it is recommended to change the brand and to space application and if that does not work, do not apply it for a full year so that the body can generate the effect again after this period. Best wishes! Alan Gonzalez MD, FACS

Camille Cash, MD · Answer

You may want to try Daxxify!  This is a new neuromodulator on the market that is made differently than Botox.  It has been proven to be effective twice as long as Botox-or even longer!  See a provider near you to learn more.

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Hi there,

I do believe that product is not FDA approved in the US so you'll likely have to leave the country for this product.  Resistance can happen unfortunately but hopefully you can find botulinum toxin B elsewhere.

Best of luck!

Resistant to Botox, Dysport and Xeomin. Any suggestions?

Answers (5)