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Why didn’t my botox work or why didn’t it last? When it comes to cosmetic procedures that are considered by many to be just as common and normal as something like keeping a hair appointment or visiting a dentist, it would be fair to say that botox treatment is right up there at the top of the list.

Botox injections are one of the most common and effective anti aging wrinkle treatments in the world, and thousands and thousands of patients all across the globe choose to get it every year in order to solve skin care issues such as crow’s feet, frown lines, sagging facial muscles and more.

What is Botox and How Long Should Botox Last?

Botox is a brand name that has become accepted as the general name where there is actually quite a range of different treatments under other brand names. Other brand names include Dysport, Xeomin, and Jeuveau. These botulinum toxins are also referred to as neurotoxins, or neuromodulators.

Botox, the shortened name of botulinum toxin, is a cosmetic treatment to smooth out fine lines and wrinkles. It is administered by injection to treat things like crow’s feet, frown lines and forehead lines. It can also be used to treat nose wrinkles (bunny lines), gummy smile, neck lines (platysmal bands), and for jaw slimming to name a few. Botox can also be used for medical issues such as excessive sweating, teeth clenching/grinding, and migraine headaches.

why didn't my botox work

Patient Before and After Botox

Botox works by blocking the nerves from sending chemical signals to the muscles that make them contract i.e. it temporarily relaxes the muscles.

It is the USA’s leading non-invasive cosmetic treatment and can be administered by medical professionals such as physicians, nurse practitioners, physician assistants, and registered nurses.

The general consensus for Botox results is that a ‘classic’ series of first-time treatments can last anywhere from 3 to 6 months depending on how much you get, how your body reacts and whether or not you experience any special or topical side effects on the treated area.

Of course, with any kind of cosmetic surgery, both invasive and non invasive, there can never be a 100% guarantee of complete success made to you by your plastic surgeon and injector. Though any dermatologist will strive to give you the best service possible, how long Botox lasts can only ever be a best guess that is based on the wider experience rather than something more specific to you.

Because of this generality, there will be rare occasions where the full effects of Botox won’t actualize on your own face. We all hope to achieve the maximum effect from the recommended number of units, but there are occasions in which a person’s Botox, Dysport, Xeomin or other FDA approved neuromodulator will not work as you wanted or last as long as you hoped.

With all of this in mind, let’s take a look at some of the most common reasons why your dose of Botox or similar kind of first treatment might not have worked in the ways that you were expecting.

Why Has My Botox Failed?

The Botox Was Handled Improperly

Botox and similar neurotoxins come in the form of a powder that needs to be reconstituted with saline before it can be used for facial expressions and anti aging purposes. If a dermatologist or cosmetic professional does not properly perfect this reconstituted mixture, it can ruin the power and efficiency of the Botox.

Aggressively shaking Botox when mixing it with saline has been proven to reduce its potency by more than 40%, and this will have a huge impact on how long the effects of the injections will reduce muscle movement. More than anything, it is incredibly important that you make sure your chosen Botox cosmetic surgeon is as gentle as they need to be to retain the powder’s power.

You Were Given An Inadequate Dose

Rather than your body having some sort of super-powered Botox resistance, one of the most common problems with shortened potency is the simple fact that you were not given an appropriate dose to start with.

If not enough units are injected into your chosen problem areas, then the muscle freezing effects are not going to last for as long as you were promised. This is why it is so important to make sure that you choose a reputable surgeon to inject your Botox and fillers. Being a vaguely unregulated side of the industry, there are plenty of untrustworthy ‘surgeons’ out there who offer Botox for a low price, and this low price will almost always be down to the fact that you are getting less Botox than you think you are.

Injections in the Wrong Place

To work in the ways for which it is designed, Botox needs to be injected into the exact right spots in the face and/or neck. If it is injected into wrong areas that don’t connect to the intended muscle location, then it will inevitably reduce the overall effect.

In fact, the side effects of a mistake like this can be even more damaging than just being a waste of money. Improper injection placement can lead to things like the unintended weakening of nearby muscles.

why didn't my botox work or why didn't it last

Always put your faith in an experienced surgeon who not only knows exactly where to place the needle but also how deep to go into the treatment area.

It is vital that you put your faith in an experienced surgeon who not only knows exactly where to place the needle but also how deep to go into the treatment area. There are always going to be slight variations in the individual anatomy of each person, and to account for this, any good surgeon will request that you contract your facial muscles for them to be located and identified.

Formation Of Your Antibodies

This might not be something that you want to hear, but another reason why Botox injections stop being as effective for people as they once used to be is the fact that they have developed a resistance to the treatment.

If Botox has worked well for you in the past, and you have gone back to your trusted surgeon but not experienced the same kinds of results this time around, then it could well be that your body has developed a resistance to the chemical effects of the botulinum toxin solution.

This particular occurrence is one of the more rare things that can happen with neuromodulators, but if you’ve previously had good results and now your usual dose has not worked in the same way, then it might be worth investigating whether or not your antibodies have formed a strong and stubborn resistance. Remember, Botox is a toxin and the body’s development of antibodies is its natural defensive mechanism in action.

Final Thoughts

Before you give up on Botox and other neurotoxins for good, it is important that you eliminate the possibilities of what might be causing the problems.

If you discover that the lack of potency in your latest Botox treatment was down to something like incorrect dosage, incorrect needle placement or incorrect handling of the important chemical ingredients, then it very likely that all you need to do is find another cosmetic professional who is more

why didn't my botox work

Dr. Michael Zadeh is a board certified surgeon with extensive experience in providing Botox and other nonsurgical cosmetic treatments to men and women.


experienced and can be more precise and successful with their handling.

If the worst-case scenario does indeed happen and you discover that you have developed a resistance to Botox, then your options immediately become more limited.

Those who are not afraid of more invasive cosmetic procedures might want to opt for a longer-lasting alternative treatment like a facelift, but for those who prefer something more temporary that requires less recovery time, there is a fantastic range of other anti-aging skincare treatments that can be enjoyed to great effect.

Treatments like dermal fillers, facial/chemical peels, microneedling, and many more are regarded as suitable alternatives to Botox. And while they cannot give you quite the same immediate results that Botox can, they will all have a positive effect on your skin.