Why Did Wrinkles Only Softened After Third Botox Treatment?

This is my third treatment with Botox. In the first 2 treatments, I was wrinkle-free for about 6 months. This time, it only softened my wrinkles. Why? Was I not injected with enough? Or in the right place? When I called to ask questions at my plastic surgeon's office, their comment was I have not given the Botox enough time to take affect. It has been almost 2 weeks.

Doctor Answers 4

Why Did Wrinkles Only Softened After Third Botox Treatment?

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Wrinkles are likely to soften even after the first Botox treatment because the muscle tension around them is abolished for the duration of the Botox affectiveness. They won't completely disappear because of the permanent collegen damage in the skin, caused by many years of muscle action folding the skin.

Toronto Facial Plastic Surgeon
4.0 out of 5 stars 11 reviews

Timing is everything, especially in Botox

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Injecting Botox is actually more complicated and technical than many people realize, both lay person and physicians. The way Botox works is temporarily weakening muscles to soften them by blocking a neurotransmitter. What I have observed is that Botox affects people differently. In some people, Botox will last 2 months, in others 8 months.

The key issue with Botox is to get a followup treatment early enough so that your lines have not returned. The rationale behind this is that Botox will have a cummulative or additive effect with each treatment.

From what you have described, Botox was effective and you waited for lines to wear off as your sign for a return for more treatment. It is better to return for treatment based on movement rather than line formation. The effects can be outstanding by having each subsequent treatment better than the previous treatment.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 181 reviews

Schedule a follow up appointment for Botox assessment

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It is great that you notified your plastic surgeon. Although I would generally consider 2 weeks adequate, you may want to ask what they consider adequate amount of time and then schedule a follow up visit for them to evaluate your response.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

The maximum effect of BOTOX is in 2 weeks.

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If you haven't seen the results you're used to after 2 weeks, they're not likely going to come. You may have received less units this time.

You should make a follow up with your doctor. Dose-adjustments are very common. I like to see all of my BOTOX patients in 7 to 14 days, and I don't charge for dose adjustments.

If your doc wants to charge $100 or less to inject more product (at cost), and make you look great, then go for it.

I hope this helps, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 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.