I've had two rounds of Botox with minimal results. Now am 5 days post-Dysport without results. Now what?

I have been using Botox since 1991 for aesthetic purposes, and in all that time I do not recall encountering a person new to Botox who did not at least in part respond to the first treatment session. Occasionally a second session a month later is needed to further enhance or tweak the result. On the other hand, I have found on a few occasions in the past 26 years that rarely previously treated patients did seem to develop some level of resistance to the product, which necessitated the use of increased concentrations or amounts of the Botox or a switch to Dysport or Xeomin. Unless I am mistaken, you sound like you are were a first time Botox patient who failed two sessions and then failed a first session with Dysport. If this is so, then I would be suspect that the fault lies with the injector treating you and not you. Perhaps he/she is not injecting properly, or over-diluting the material to save money. What I would not advise right now is any more of the current treatments, as too many treatments spaced too closely together do pose at least the theoretical risk of inducing antibodies to the injectable products, which may then render them ineffective going forward. Whatever the reasons for the failures in your case, I would strongly urge that you seek consultation with a board certified aesthetic physician with experience and expertise in injecting all the current neuromodulators. Make sure to ask to see his/her personal collection of before and after photos before proceeding.  

It is highly unlikely that a patient would have zero response to Botox or Dysport when injected properly in the proper dosage. Some patients require more units than others, but this dosing varies from one person to the next. I always tell my patients that their lines will not disappear immediately, and in some cases, may never completely disappear if the lines are very deep initially. In almost all cases, the lines will soften over time as the skin remodels while it is no longer being repeatedly creased by dynamic muscle movement.
I always recommend speaking to the doctor who performed your injections about any questions or concerns. Be sure to see an expert physician injector who specializes in facial aesthetic procedures.All the best,

This is extremely unusual. I would wait the two weeks and get re-evaluated by your injector. If all of your injections have been done at the same facility, then consider going elsewhere next time.Additionally, if non-surgical rejuvenation does not work for you, perhaps considering facial surgery might be the way to go. Xeomin is another neuromodulator you can consider before going towards surgery. Best wishes, Dr. ALDO

Botox and Dysport are two brands of botulinium.  These ‘brands’ are from different companies and both are very effective in reducing unwanted muscle actions in typically in the upper part of our faces. Both types take a few days to begin to work, then peak at 2-3 weeks, gradually tapering off over time. At 3 months most muscles have recovered. So be patient while it begins to work.

It can take 1-2 weeks for final results with Dysport. Xeomin, lasers and microneedling/prp are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

These products work when you treat with sufficient product in the right location.  Unfortuately these services are much more profitable when office water down product. Choose your injectors carefully.

Thank you for your question.  It is
extremely rare for an individual not to respond to multiple neuromodulators
(muscle relaxers), however, it is a real possibility that this can occur.  There have been cases where the patient’s own
body resists the effects of the neuromodulators and this can transpire for a
host of reasons.  It is also important to
note that there are other factors at play when it comes to results – the amount
of neuromodulator injected, the location it is injected, the reconstitution of
the product, the skill of the physician, etc. 
It is probably best not to have injections more frequently than 2
months. Please seek the care of the a board certified dermatologist or plastic
surgeon who has extensive training and experience as they will be able to best
help you plan next steps.

I would wait another 7 days before going back. It is really rare to be immune to 2 types of immunomodulators but it is possible. I have never seen this but is reported in the literature. Best of luck.

I cannot recall a single patient who did not respond to two different types of neuromodulators. Given that it has been 5 days post Dysport, I suggest that you wait another 5 days before you conclude that there product did not work. If you still don't see any results at that point, I suggest that you consider going to another expert physician for further assessment. There are many other variables, other than the choice of the product, including total number of units, reconstitution (how the product is mixed) and most importantly technique of your physician (injection points) etc that will ensure best results! 

Thank you for your question. Results of Dysport and Botox depends upon the dosage and placement of the product. If you had multiple treatments from the same injector with minimal to no results. I would suggest you find a new injector. Best of Luck!