Why doesn’t my botox last?

Is your favorite anti-wrinkle injection not giving you the same results it used to?

Neurotoxin resistance is when a person experiences either underwhelming results, a very short-lived effect, or no effect at all after receiving treatment with botulinum toxin, the active ingredient in anti-wrinkle injections. True neurotoxin resistance is rare. However, there are a number of reasons why you may be experiencing less of an effect. We will explore these reasons in this article.

You switched providers and your new provider is still getting use to your muscle and skin response.

If you have recently switched providers, it is possible that your new provider is still getting to know your specific response to the dosing. Not everyone responds in the same way and it is safer to under dose than to over dose. When switching to a new provider, it can take a visit or two to get to know your individual response to treatment. Be sure to contact your provider as they would want to know if your response was less than what was anticipated.

You haven’t waited long enough to see full results.

While you can start seeing changes within a couple of days, full effect can be appreciated after 14 days.

You are requiring more units due to natural aging process.

If you have been receiving the same number of units for years, it is possible that you have outgrown that dose due to aging factors.

A new medical condition has developed.

It is possible to have developed a new condition that causes you to breakdown the neurotoxin at a quicker rate. For instance, those with faster heart rates will metabolize botulinum toxin faster than those with normal resting heart rates. Also, persons who are active with cardiovascular workouts will also metabolize faster.

You have developed an immunity.

There is a small percentage of individuals who can develop an immunity to botulinum toxin. This is thought to be due to the accessory proteins. During the manufacturing process, there is an inactive component called “accessory proteins”. All of the available neurotxons (Botox®️ Cosmetic, Dysport®️, Jeuveau®️ and Daxxify®️) with the exception of Xeomin®️ have these excess proteins to some degree. Theory is that with repeated use, your immune system can respond by creating antibodies to the accessory proteins thereby inactivating the product upon entry into the body. For this reason, Xeomin®️ is our preferred neurotoxin in our office and our patients receive excellet results.

Additionally, those previously treated for botulism will have built up natural immunity to botulinum toxin and therefore, will not respond to any of the neurotoxins available.

You just happened to respond better to a different neurotoxin

Just like some people find better pain relief with Advil®️ instead of Motrin®️, the same can be true for neurotoxins. You may have a better response to a different neurotoxin. For example, in our practice, we find a number of people who did not respond well to Dysport®️ in the past but have excellent response to Xeomin®️.

There was a problem with the product you were given

Although rare, there could potentially be an issue with the product from the manufacturer. This is uncommon but is a reason all lot numbers are recorded and the proudct is inspected before injecting. We also are meticulous in the storaging of our neurotoxin. It is also possible that you were under-dosed - you were given less units than usual. It is also possible you received a fake product. The availability of unlicensed product has significantly increased in recent years. This is a very dangerous and unethical practice which is why we always recommend you go to a reputable place with a knowledgable professional experienced in cosmetic medicine and has an extensive knowledge of anatomy - preferably a medical doctor.

What to do if your favorite anti-wrinkle treatment is no longer working?

First, you should contact your provider. If it is less than 14 days from your treatment, they will most likely have you wait until that time period is up as you don’t want to add more units until the current dosing has settled in. If it is more than 2 weeks from treatment, then most reputable providers would want to have you come in to take a look so they can troubleshoot the inadequate response. In the event, you do not feel comfortable returning and desire a second opinion, we recommend bringing your new provider a record of your previous treatments, including when you last had treatment, where injections were made, and how much was given. This information will help them design a safe, effective treatment plan.