Why Botox does not work and why it fails

Why Botox doesn't work

In the field of aesthetic medicine, it’s hard to find an anti-aging treatment as popular as Botox injections. However, amidst the expectation of a youthful face without fine lines and wrinkles, some women and men alike are faced with the frustrating reality of “Botox resistance” and other factors that lead to treatment failure.

Botox resistance

Botox resistance is an upsetting scenario where the benefits of the treatment are not what one would expect! See why this may be the case. When you have Botox, there is a slight chance that the body produces antibodies that reduce the effectiveness of future treatments by turning off the biological activity of these botulinum toxin.

Scientists have shed light on this rare phenomenon of these Botox resistance, citing clinical studies that actually confirm that a minimal percentage of patients develop antibodies against these botulinum toxin.

In three studies focused on the treatment of fine lines in the goose leg, a total of 916 patients received Botox injections. Samples from these subjects were analyzed to detect antibodies. Of these, 14 subjects (1.5%) developed antibodies.

Although it is very unlikely that you will develop antibodies to Botox, it may still be one of the reasons why your treatment is not working. More likely to develop antibodies are people who have been doing high doses of Botox for a long time for therapeutic purposes, such as in cases of cervical dystonia, half-face spasm or chronic migraine.

However, antibodies alone should not be blamed when you don’t get the result you would like after Botox treatment. A number of other factors besides botulinum toxin resistance come into play, and each presents unique difficulties that must be overcome.

So what are the additional factors that can lead to Botox failure?

The results are not immediate

One of the reasons that lead to disappointment after treatment is that Botox results take some time to show. Every day we are bombarded with advertisements stating that Botox results are immediate, which is far from reality. This is one reason why some patients call the doctor just a few days after the treatment to express their concern about the results.

Botox works on a timetable that progresses gradually, with changes often taking two weeks for the final result. It is advisable not to jump to conclusions and to allow the time needed for the treatment to take full effect.

Counterfeit formulations or fake Botox

In a market flooded with imitations and fakes, unsuspecting consumers may buy inferior products sold as Botox that, at best, will not bring about the desired results. Such fake Botox products that we have seen often offered at discounted prices, not only in Greece, but also internationally by some spas and beauty centers, put at risk both the safety of patients as well as the effectiveness of the treatment. A simple way to protect yourself is to ask your pharmacist how much 100 ml of Allergan Botox or Dysport cost at wholesale to realize that the profit margins for a doctor are very small. So when you see offers of 100€ – 150€ all over the face, it is advisable to investigate further.

Whether through diluted formulations or blatant imitations, the effects of counterfeit Botox can be severe, resulting in extremely poor quality results or none at all, as well as health risks.

The experience and expertise of the doctor

The experience and expertise of the physician plays a crucial role in Botox injections. In many cases, the reason why Botox does not work is due to its incorrect injection. Whether it is due to sub-pharmacology or improper technique, sub-standard injections have an impact on the effectiveness of the treatment.

For example, if the dose administered is inadequate or the drug is over-diluted, the desired results are most likely not to be achieved. Similarly, incorrect application of technique, such as mis-targeting the muscle or injecting at the wrong depth of the skin, by an inexperienced practitioner can have complications in addition to treatment failure.

If you have recently changed practitioners and the result is not to your satisfaction, you should discuss it with them. It is very likely that he gave you a smaller dose to test your body’s reaction, so you should give him time.


The aging process makes treatment more complicated, with the changing physiology of the face requiring an adjustment in the treatment approach. As collagen and facial fat levels decrease over time, once effective doses of Botox may prove inadequate.

This means that a combination of Botox and injectable fillers such as hyaluronic acid will be needed to restore lost volume and skin vitality. It may also mean that you may need to stop Allergan Botox and try Dysport.

Different approach in men and women

Although Dysport and Botox contain the same substance (botulinum toxin), the approach differs in men compared to women. Men have stronger muscles in the face, which will require a higher dose. In general, men are recommended Dysport.

What to do if the results are not satisfactory

One reason may be that you did not take proper precautions after the treatment.

In any case, if your Botox did not work, express your concerns to your doctor. This will help you get a better result. Whether it’s seeking a second opinion, exploring alternative treatments, or making a detailed dosage adjustment, constructive dialogue between patient and doctor is essential to have a safe treatment that meets your expectations.

Why choose us for your Botox

If you are interested in Botox, at Cosmetic Derma Medicine the treatment is provided by qualified physicians, such as Dr. Amalia Tsiatoura, Dr. Konstantina Mamali and the other dermatologists and plastic surgeons at the Clinic, who safely provide high quality services and the best materials to ensure the results meet your expectations.

Book a free consultation now, where we will discuss your goals and concerns and answer any questions you may have to find the most appropriate treatment for your needs. To contact us call one of our 15 Clinics in Greece and Cyprus or leave a message and we will get back to you as soon as possible.