To put it plainly, Botox resistance (immunity) does occur in some patients. According to those who do recognize the phenomenon of Botox resistance, the numbers are low—about 1% to 3% of patients who are injected will develop toxin-blocking antibodies.
Again, the chances of being a true non-responder to Botox are extremely low. There are also no tests to determine if you have antibodies to Botox. However, there are a few things that can increase your chances of being a non-responder: If you received Botox prior to 1996.
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.
The only true way to overcome resistance to botulinum toxin is to wait for the antibodies to disappear from your bloodstream. Unfortunately, this can take 4 to 5 years to happen. In the meantime, your doctor might recommend other treatments that could achieve a similar result.
The same scenario can potentially occur with BOTOX. Over time, your body can develop antibodies and render it ineffective. But the good news is that this is extremely uncommon and most high volume injectors (such as myself) rarely see this happen.
Why does Botox eventually stop working? Your body makes new neurotransmitters all the time, so the “blocking” effect of Botox gradually wears off as these chemicals start circulating in your body again. The muscles are no longer inhibited.
Many people see absolutely no change at the 2-day mark after BOTOX injections. It usually takes about 7 to 10 days for full results to develop. If you don't see any change by that point, consult your injector, who should be able to give you an explanation and improve your treatment.
Because Botox is a form of a toxin produced by a bacteria, the body can sometimes develop an immune response to the injections. This will cause the body to break down the Botox injections quickly so that they are no longer effective.
Botox® injections work well as a standalone treatment for mild to moderate frown lines. However, if the 11s are deep, Botox® alone may not be enough to reduce the appearance of forehead wrinkles. For the best results with deeper 11s, dermal fillers can be used along with Botox® treatment.
There is no upper age limit for people who want to have Botox. In fact, many women enjoy the refreshed look they can get from Botox and complementary treatments when they are in their 60s or older.
Botox can reduce the appearance of static wrinkles as well, but not as effectively as dynamic wrinkles. If you have static wrinkles, you should consider dermal fillers, i.e., injectables that infuse your skin with hyaluronic gel or trigger collagen production to temporarily fill the status wrinkles and fine lines.
Some products that may interact with this drug include: certain antibiotics (including aminoglycosides such as gentamicin, polymyxin), anticoagulants (such as warfarin), Alzheimer's disease drugs (such as galantamine, rivastigmine, tacrine), myasthenia gravis drugs (such as ambenonium, pyridostigmine), quinidine.
It sounds like the muscle has been knocked out with the dose you received. It will take many weeks or even months for the crease to smooth out and it is important to keep up with the Botox to keep those muscles knocked out or they will once again work on the overlying skin to reform the wrinkles.
When some people see their wrinkles form again after the rejuvenating effects of Botox wear off, they assume that the treatment made their wrinkles worse. This isn't true at all. In fact, regular Botox use can actually retrain certain muscles to move less, leading to smoother skin with less Botox over time.
It's rare to see cases of Botox being ineffective on the forehead especially if it was administered by a qualified and experienced provider. Despite its high efficacy rate, there are cases when Botox injections on the forehead don't produce the same results clients expect.
Answer: Botox takes a while to work
Once the muscles stop contracting, the lines can take quite a while to disappear in some patients. If you continue to maintain the inability of the muscles to contract by having repeat Botox before the muscle wakes up ( around 3 to 4 months), the lines should continue to improve.
"After receiving Botox, a patient may unconsciously attempt to re-create the facial expressions in the area where treatment has paralyzed their facial muscles, "said Dr. Becker. "What can happen is that other, nearby muscles compensate--this can have the effect of actually creating new wrinkles."
The appearance of vertical lines after Botox is due to its unique utilization and weaving. The corrugator muscle is responsible for creating the inter-brow number "11" creases. Once these muscles are crippled, the brain recruits the orbicularis oculi to produce the same expression.
The most common reason that Botox does not work is that not enough was given. Botox is not a one size fits all treatment and the same dosage does not work for everyone. Some individuals may need additional Botox to reach an effective level of muscle weakness. The Botox may also be old, overdiluted, or fake.
Many people worry that if they stop getting BOTOX injections, their wrinkles will come back faster and worse than before. However, this is not the case. If you stop BOTOX injections, your wrinkles will slowly start to come back, but slower than if you had never used BOTOX to begin with.
“If you're starting with skin that's healthy, your Botox and fillers will last longer,” contends Dr. Peredo. Her medicine-cabinet recommendations include products that contain retinol, hyaluronic acid, peptides and antioxidants. “Having good skin care will also help extend your results.
Take a Zinc Supplement
In a study from the Journal of Drugs in Dermatology, researchers found that people who received Botox and then took a 50-milligram zinc supplement saw a significantly longer duration in their results.
“It's customary to provide an 18 to 20 percent gratuity for any spa service, no matter if it's sugaring or a Biologique Recherche facial,” Angela Rosen, owner of Penelope & The Beauty Bar in Seattle and Daphne in New York City, tells Allure.