Xeomin 25 Units, 12 Days Out, Not Working? (photo)

I received 25 units of Xeomin to the glabellar region exactly 12 days ago. I have had Botox once before at the same facility (different injector) and although it wasn't perfectly smooth, I had far less movement than I do this time around. I feel like I can fully contract my muscle. I go in for my follow up in 2 days and I know if they do add more units, they charge. I'm frustrated because I don't want to waste the money I already spent but I want true results like I see here. What do you think?

Doctor Answers 10

Xeomin 25 Units, 12 Days Out, Not Working?

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You need to speak with your plastic surgeon.  There is a small percentage of patients who are unhappy with the results of any of the neuromodulators, but, in general, adding more product should help.  With Xeomin, more so than with Botox and Dysport, it is important for the plastic surgeon to make sure that all of the precipitate, some of which may be under the cap, has been incorporated into the solution.  Not doing that may reduce the effectiveness of what is injected.  And going to the same MD is another component in comparing treatments.

I would recommend that you start with a discussion with your PS and you will hopefully be able to work it out from there.

I hope that this helps and good luck,

Dr. E


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Please discuss your concerns with your injector.  You may require more units of Xeomin or you may be a better candidate for Botox.

Martie Gidon, MD, FRCPC
Toronto Dermatologist

Xeomin - 2 weeks after treatment

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Thank you for your question.

I am sorry to hear that you feel not happy with your treatment results. You had a normal dose. However, 3% of Botulotoxin users (regardless what type of product: Botox, Dysport, Xeomin) can become resistant to the effect of toxin. It looks like you one of these people. Discuss this with your practitioner.

Xeomin not working

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In most cases where inadequate correction occurs with neuromodulator injections, the problem can be solved with adding additional neuromodulator (Xeomin in this case). Be sure to speak with your injector regarding any post-injection concerns.

While some injectors will charge by the area, and others will charge by the unit, each injector is different on how they handle the need for additional units and the fees involved. Personally, I want to make sure my patients get a good result and are happy, so I work toward that goal and costs are a secondary concern.

Always see an expert physician injector.

All the best,

Matthew Richardson, MD
Frisco Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews


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I would follow up with your provider for recheck as you indicated. Typically this is not  the result you would expect from 25 units in the glabellar area.

Poor Xeomin result

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It does not look like the Xeomin injections were effective.  You have waited an adequate amount of time for the full response.

We do not know if the amount injected was the same, whether the concentration was the same.

You also had a different injector who may not have been experienced as the first person who injected you. Maybe the pattern and depth of injection was different.

Go back and speak to the head doctor at the office where you were treated and explain you concerns.  I am sure they will work things out to your satisfaction. 

Harry Goldin, MD
Skokie Dermatologist


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Thank you for your question.

It appears that you have strong corrugator muscles which may require more units of Xeomin/Botox to achieve your desired results. Discuss your concerns with your provider at your follow up appointment for additional options. To be sure what is best for you, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews


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Hi Kat, I feel your frustration, and I sometimes have patients who need a little more to smooth things out.  Be up front with your frustrations.  Xeomin absolutely will work, but you will need more.  Talk about alternatives also.  So, go back in, tell them you are frustrated, and see if they can cut your some slack on fees.  This is how I handle it.  All the best, "Dr. Joe"

Xeomin injections in Santa Monica

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Xeomin is an excellent alternative to Botox and works well. Discuss your concerns with your physician. Our office has seen excellent results with Xeomin injections. 

Raffy Karamanoukian MD FACS

Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Xeomin 25 Units, 12 Days Out, Not Working?

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You seem to have strong corrugator/procerus muscles and would benefit from a higher dosage of Xeomin to see full correction. Contact your provider for further assistance, you may want to continue using Botox if you're not seeing a significant difference with Xeomin

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.