Q. No change in 11s after re-injection of Botox. Could it be that they are using old Botox? I had a Botox injection 6 weeks ago in my forehead and crow’s feet areas, I had to re-visit the spa because my glabella had no noticeable change after 2.5 weeks. The MD was not pleased with the way the nurse injected the botox originally because he pointed out that the area above my eyebrows looked flat. He re-injected me with additional botox in the glabella and I still have not had any change in my 11s. Could it be that they are using old Botox? I feel as though I wasted my money!
A. Botox is a injectable muscle relaxer. In thousands of injections, I have yet to see it not work but there are non-responders.
These include:
1. A patient whose muscle of expression has had multiple injections
and atrophied to a point where no contraction occurs. If a muscle elsewhere showed relaxation or less movement, then the non-responding muscle is due to its atrophy.
2. All other reasons:
· antibodies against the neuromodulator
· old Botox
· poor technique
· use of medication or non-medication not a neuromodulator
· inadequate number of units or over dilution of the neuromodulator
The continuous use of a muscle of expression in the face, like any muscle wrinkling skin elsewhere on the body will thin the fat directly under the crease and thin the dermis which forms the visual line in the skin. In between the eyebrows, this can form the appearance of an “11”. You may need filler at various levels to assist the skin to repair the dermal damage and fill the fat loss.
This is an advanced technique in this area due to a added risk of problems. Consult with a well experienced, Board Certified Plastic Surgeon, ENT Facial Surgeon and / or Dermatologist for evaluation and your best results. No change in 11s after re-injection of Botox. Could it be that they are using old Botox?
Q. No change in 11s after re-injection of Botox. Could it be that they are using old Botox? I had a Botox injection 6 weeks ago in my forehead and crow’s feet areas, I had to re-visit the spa because my glabella had no noticeable change after 2.5 weeks. The MD was not pleased with the way the nurse injected the botox originally because he pointed out that the area above my eyebrows looked flat. He re-injected me with additional botox in the glabella and I still have not had any change in my 11s. Could it be that they are using old Botox? I feel as though I wasted my money!
A. Botox is a injectable muscle relaxer. In thousands of injections, I have yet to see it not work but there are non-responders.
These include:
1. A patient whose muscle of expression has had multiple injections
and atrophied to a point where no contraction occurs. If a muscle elsewhere showed relaxation or less movement, then the non-responding muscle is due to its atrophy.
2. All other reasons:
· antibodies against the neuromodulator
· old Botox
· poor technique
· use of medication or non-medication not a neuromodulator
· inadequate number of units or over dilution of the neuromodulator
The continuous use of a muscle of expression in the face, like any muscle wrinkling skin elsewhere on the body will thin the fat directly under the crease and thin the dermis which forms the visual line in the skin. In between the eyebrows, this can form the appearance of an “11”. You may need filler at various levels to assist the skin to repair the dermal damage and fill the fat loss.
This is an advanced technique in this area due to a added risk of problems. Consult with a well experienced, Board Certified Plastic Surgeon, ENT Facial Surgeon and / or Dermatologist for evaluation and your best results. 
