Why don't I see the same results from Botox that I did the first time?

I got Botox 5 months ago for the first time and LOVED the results. I saw immediate change and by the 4th day the frown lines were "gone". instead of going to the same office I purchased a Groupon for half the cost. I read the reviews and looked into the staff before booking my appointment. This time with the Groupon office it's been 4 days and there is ZERO change! Should I call the second office and try to get a touch up? Why didn't i get the same gorgeous results?

Doctor Answers 19

Give Yourself More Time

Even on the same patient, no 2 BOTOX treatments are exactly alike. It's not uncommon for the very first treatment to yield quicker results than subsequent treatments. Allow yourself 2 full weeks from your appointment to see results. That said, no 2 BOTOX injectors are exactly alike, either. If you pass the 2-week mark without seeing any change, give your practitioner a call to revisit your results. 


Idaho Falls Plastic Surgeon
4.8 out of 5 stars 8 reviews

Botox results!

Full effect of botox may take up to 2 weeks.  Thus it would be prudent to allow 2 weeks to pass prior to following up for additional units. 

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 45 reviews

Botox results

Results from Botox take a full two weeks.  After two weeks you can follow up with your provider if you still have concerns.  

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 425 reviews

Botox results

I would recommend requesting to see a before and after photo 7-10 post treatment. It is often very enlightening for a patient to see the difference that has been made in their skin's texture. The degree of movement your are still experiencing is the best bench mark by which to judge whether or not the product is working or was injected in the correct dosage.

Justin Harper, MD
Columbus Physician
5.0 out of 5 stars 15 reviews

Botox Treatment is an Art Form!

There are many, many possible reasons for your disappointment. I simply would like to share my advice -- I would not choose Groupon or any discount "offers" when it comes to having medical or surgical treatments on your face.  I would suggest you seek out treatment from a board certified facial plastic surgery expert (not any other kinds of "injectors").   Botox/Xeomin treatments require exquisite knowledge of facial anatomy and the aging process. It is possible that the Botox was the wrong dose, overly diluted, or was injected with insufficient knowledge.  Also possible is that it can take up to 2 weeks for the full effects of Botox to be seen.  Once you choose a Plastic Surgery expert to treat you, you can develop a rapport with him/her and they can artfully sculpt your face so that you will look your very best.  Good luck!

Damon B. Chandler, MD
Moorestown Oculoplastic Surgeon
5.0 out of 5 stars 2 reviews

When to expect results after Botox

Thank you for your question Skreger95. I am sorry to hear about your experience. Botox is a great treatment to address the frown lines seen between the brows. The standard dose for this area is 20 units based on the pivotal studies. Most people enjoy their results for three to four months. With Botox it can take up to two weeks to see full results, so I tell my patients to be patient. I have seen patients who got results in a few days after one treatment, but it took two weeks to see full results after another treatment, even when the same dose was used. There is small variation from lot to lot and sometimes this can happen. For this reason I always have patients come back two weeks after their treatment to assess their results and possible add additional units for any correction, if necessary.
Groupon is a great service where people can try new businesses at an introductory price to see if they like it. Unfortunately it is not always ideal for cosmetic services. This is because the price is typically discounted at least 50% and Groupon takes usually half of that. So businesses are receiving one quarter of what they typically receive for a treatment. Given this dilemma, many offices use this as a tool for welcoming new patients and offering other services or educating patients about other concerns that can be addressed with that treatment. I have patients who come to me telling me that they got an online promotion from another office and did not get full results. I cannot comment on what other offices use but many patients raises suspicions. I tell my patients that cosmetic treatments such as Botox are treatments, not commodities. For example, if you want a can of coke you can get it from a vending machine, gas station, supermarket, etc. At the end of the day it's the same coke. Botox on the other hand is a treatment and is performed by an injector. So it is important to go to an office with an experienced injector. Look for their experience, before and after pictures, and reviews. Most of my patients would not go to the cheapest stylist for a haircut because they know that they get what they pay for. So why would they go to the cheapest office for Botox? The results of a bad Botox treatment can be worse than that of a bad haircut. I ask my patients if they would go to two different stylists, would they expect the same result. If not, then they should not expect the same result after a Botox treatment from two different offices, or even two different injectors, from the same office or a different office.
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 mixed results

There are many reasons for the problem you have but most likely either the Botox was more dilute, the wrong dose was used or the injector was inexperienced. Go back to where you were before and even though it usually takes 7-10 days to see the effect some patients Like you see it earlier. 

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

Botox Results

I'm sorry you had a disappointing experience! We recommend our patients wait approximately 14 days to fully evaluate their results. Because 5 months ago was your first time using Botox, you may have seen more of a contrast in your results than your second time.  Additionally, you can contact the office to see how any units of Botox were used. Since it was a special offer, it may have been fewer units than what you originally received. Good luck!

Jennifer Levine, MD
New York Facial Plastic Surgeon
4.3 out of 5 stars 24 reviews

Botox and Results

Results take 2 weeks to take effect. If you are unhappy after, please go in for more or see an expert.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Not getting the same results

Thanks for your question.  The results of Botox can take up to 10 days before you see the results.  I always tell my patients to call or come in if they have concerns.  You can always ask your injector how many units of Botox they used to see if it was the same amount as the first time you had Botox. Best of luck!

Michael Sullivan, MD
Columbus Facial Plastic Surgeon
4.9 out of 5 stars 78 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.