Why doesnt botox last on me

If there were such as thing as a “slam dunk” wrinkle treatment, BOTOX would probably be it. When administered by a qualified provider, it’s rare that BOTOX doesn’t achieve the desired result. Occasionally, however, BOTOX will seem to have little effect for a patient. If this has happened to you, you may have Googled the issue and come across the concept of “BOTOX resistance.” Furthermore, you may wonder, “am I immune to BOTOX?” (probably not) and “is there anything I can do about it?” (almost certainly there is).

Given the topic is somewhat complex and has generated confusion, I thought it would be helpful to provide a professional medical opinion on the subject, including the most likely reasons BOTOX may not seem to work.

What is BOTOX resistance?

BOTOX resistance is a situation in which a patient either has built up antibodies against the botulinum toxin, or happens to metabolize the BOTOX drug exceptionally quickly. As a result, for these patients BOTOX injections provide underwhelming results, a very short-lived effect, or no effect at all. True BOTOX resistance is fairly rare—manufacturer clinical trials showed that no more than 1.5% of patients developed any “neutralizing antibodies” to the drug. Other doctors estimate that as few as 1 patient in 10,000 has real BOTOX resistance.

Most of the time, when BOTOX seems to be less effective for a patient, it is not a case of true BOTOX resistance. Rather, it is one of the following:

You haven’t waited long enough for BOTOX to take full effect

One of the benefits of BOTOX is that it works quickly—but not instantly. While many patients notice fewer wrinkles in as little as 48 hours, it is normal to take up to 10 days for full effects to realize. In other words, you may need to be patient. If it has been more than 2 weeks and you are still not seeing the results you expect, consult with your provider.

You’ve switched to a new provider who is still getting to know you

It is far safer to undertreat with BOTOX—there’s nothing you can do about too much BOTOX besides wait for the effects to wear off—so providers will often be a little conservative the first time they work with a patient. If you’re seeing someone new, and they have a great reputation otherwise, chances are they are just taking this approach to dial in the appropriate dosage. Call them if you aren’t seeing results after a few weeks; usually the solution is simply a matter of touching up your results.

The natural aging process is catching up, and it’s time to update your injectables protocol

If you’re a BOTOX regular, it can be easy to forget that the aging process continues “behind the scenes.” If the same dose no longer gets satisfying results, it may be that your skin has lost collagen and elastin and/or your facial fat volume has decreased. Either change can cause lines that were once only bothersome with facial expressions to deepen. In this case, more BOTOX is unlikely to be the best solution. Instead, a treatment plan of BOTOX plus injectable fillers to plump up the skin can help you maintain a youthful look and your natural facial expressions.

Your provider made a dosage error or injected in the wrong location

A thorough knowledge of facial anatomy, as well as an ability to interpret a patient’s goals and apply the correct dosage based on their skin quality, are essential for anyone performing cosmetic injections. This is one reason I continue to perform injections personally for my Eugene BOTOX patients. Less experienced providers are prone to mistakes such as using the wrong dose or injecting in the incorrect point on the facial muscle, both of which can result in underwhelming results or worse. Minimize your risk by choosing an experienced provider with a proven reputation for achieving excellent BOTOX results—preferably an MD with extensive training in cosmetic medicine, such as a board certified plastic surgeon.

You’re a patient who just does better with Dysport

Everyone is different. Just like some people swear by Advil for headaches and others by Motrin, some patients get better results with Dysport than BOTOX (and vice-versa), even though the two products are very similar. A provider who is experienced with both can help you determine if Dysport is a better alternative to BOTOX for you.

You were given over-diluted or fake BOTOX

Unfortunately, there are unethical providers out there who sell discount “Botox,” which is either heavily diluted to maximize profit margins, or isn’t real BOTOX at all. The risk of this happening is much higher at salons and other non- or quasi-medical venues, as only licensed physicians can obtain authentic BOTOX or Dysport. To avoid potentially dangerous consequences of fake or badly performed BOTOX, only let experienced, qualified medical providers at reputable medical practices perform your injections—and never trust prices that seem too good to be true.

What to do when BOTOX doesn’t work as well anymore

First, get in touch with your provider. A reputable injector will want to know when you are not fully satisfied with your treatment, and should work with you to ensure that you are satisfied with your results. That said, if you are wary of returning to the same provider for any reason, get a second opinion or switch to an MD injector before you invest in additional BOTOX. Bring your new provider record of your previous treatments, including when you last had BOTOX, where injections were made, and how much was given. This information will help them design a safe, effective treatment plan.

If you are looking for an experienced BOTOX provider in Eugene, I invite you to schedule a consultation with me at Movassaghi Plastic Surgery. We’ll discuss your goals and concerns and address any questions you have to find the most appropriate treatment for your needs. If we agree that you are a good candidate for BOTOX, it’s usually possible to begin treatment that same day. To make an appointment, call 541-686-8700 or contact us online.

Are you one of those people who love the effect of Botox on your forehead lines, frown lines and crow’s feet, but are frustrated by the fact that the smoothening effect disappears in a few short weeks?

The muscle action, which had been paralyzed by the Botulin toxin, quickly returns, the lines and wrinkles begin to reappear and need to be treated sooner than expected.

Why does this happen when the effect of Botox is supposed to last on average four months?

Well, here’s the most probable answer, one that the practitioner at your clinic may not be telling you.

You are being underdosed!

Scientific studies tell us that for the average person, you need 64 units to treat the three main areas: forehead lines, frown lines and crow’s feet.

Also, if you have strong muscles, you may just need more. Muscles in different parts of the face require different amounts of Botox, depending on the size of the muscle and how active they are.  For example, a man often requires 50% – 100% more Botox in his frown lines because the corrugator supercilii muscles are just larger and stronger.

But some people who are unwilling to spend more than a certain amount for each treatment have been chronically undertreated because the injector has been relatively timid, injecting less Botox just to please the patient.

The result? Well, you already know it because the effects are disappearing much sooner than you anticipated.

“Being prepared to pay for only a certain amount of Botox is a bit like taking your car for an oil change and telling the attendant to change only 2 quarts of oil and leave the rest unchanged. No wonder the effect does not last as long as expected,” says Dr Bryan McIntosh, a plastic surgeon who believes optimal doses last the optimal time. “I only know what science says, and I like to use science in my practice. This is a medical treatment after all, and as a practitioner, I want to do the best thing. I don’t want to have people needing to come back every couple of months because that’s not in their best interest.”

Another factor that affects the longevity of each treatment is an erroneous belief among a lot of patients that “less is more”. They draw parallels with a friend or a relative perhaps, who needs only 30 units and insist with their provider that a similar amount will work for them as well.

But as explained above, the dosage is not cast in stone. One amount does not suit all. Not if you want the best results from your Botox treatment and have it last the expected period of time. Returning earlier than expected to have it redone costs a whole lot more in the long run.

Finally, the skill of your practitioner can also be a factor that is impacting the longevity of your treatment. Botox has to be injected in the right places and at the right depths to get the best results. Less experienced practitioners may not fully understand facial anatomy and muscle structure as well as they should.

Interested in getting treated with Botox the right way by an experienced plastic surgeon, who will explain the science behind the treatment you’re receiving?

Let us know! At Dr Bryan McIntosh’s practice, we take great pride in the satisfaction our patients enjoy after a Botox session, and we want to do the same for you!

REQUEST AN APPONTMENT >