Injecting stronger Botox solution. Is this safe?

Thank you for your question. It may be the case that over time you have developed a resistance to Botox, making it less effective. However, that is a somewhat rare occurrence. If you have tried other neuromodulators, you might find that combination treatment with dermal filler helps around the eyes for a liquid eye lift. There are also other treatment options outside of injectables like laser treatments and RF microneedling that can help with fine lines and wrinkles and is safe to use with dermal fillers. Consult with an experienced, qualified injector to determine what treatments and combinations are right for your cosmetic goals.

I doubt that a more concentrated dose of Botox will make a difference if the number of units is the same. It is also possible that after 10 years, you have experienced some normal age-related changes that Botox is not the best option for. Get an opinion from a plastic surgeon to see if a brow lift or eyelid surgery is indicated.

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

You can dilute botox to whatever strength you would like, knowing that the muscle will respond differently. Most people dilute to 4 units in 1/10 of a cc. This is the most effective dose to soften wrinkles but not to overpower the muscle in a small spot. It is safe to do whatever dilution you want, as long as you have an understanding of what it is going to do. I suspect someone may be injecting too deep meaning that the botox is not going into the muscle itself, but has to make its way there through the tissue. A stronger dose injected in the right spot should help unless you have developed an immunity to botox (which is very rare). More importantly, work with your injector over time, ask questions about the anatomy, their approach, philosophy, and "what ifs" so you can get the sense of whether they know what they are talking about or not.

Hello! It is most likely that you have developed a resistance to the neurotoxin. The dilution is unlikely to be the solution to your problem. Over time, as resistance develops, patients begin requiring more units during their treatments. Another option would be to try a different neurotoxin and ensure the units given are a full treatment. If you have already tried Dysport, I would suggest trying Xeomin or Jeuveau.

Good day and thank you for your question. Given the length of time you’ve been using botox injections, it is likely that you have developed a resistance to it. I would consider trying a different product such as Xeomin and see if you have a better response to it. I would not increase the dose of the botox as your first option. Good luck with the rest of your journey!
Cheers, Dr. Joseph BatacDouble Board Certified Plastic Surgeon

Botox has a recommended dilution, but each injector can vary it as preferred. The dilution is not the key. The key is the number of units injected. It may be that the number of units used previously no longer yields the same result for you, meaning you need to increase the number of units used for a given area.

Thanks for your interesting question. Any provider can dilute the toxins to a concentration they are comfortable using. Some studies in the dermatology literature are showing that higher doses of total toxin have a longer lasting duration. You can also try Xeomin or Jeuveau which are slightly different but essentially have the same efficacy and duration as Botox. Ask your provider for options and if they are well-trained, board certified in dermatology or plastic surgery, and have a good reputation and continue to do training and research, they will probably be able to discuss the risks and benefits of different concentrations of toxin and what your choices are. Best of luck!

If you have developed Botox resistance you may need a higher dose after all. If you have developed more of an eye droop you may need an ocular muscle surgery. Another consideration is PDO threads if the lines are static when you are making a facial expression. A thorough exam would be needed.

It’s not the amount of the saline added to a reconstitute Botox that matters, what matters is the number of units that is injected into any particular area of treatment. Botox, Dysport, Xeomin and the like either work or they do not. You are safe. I hope this answers your question and good luck from your shitty plastic surgery