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"My Botox Isn't Working": An Updated Guide to Why Results Can Vary (And How to Optimize Treatment)

I recently found that the original version of this blog is our most clicked on blog of all time (six years I've been writing blogs)! So I thought I'd update it a little and repost. Sometimes clients call and say “my Botox didn’t work this time" or that results wore off faster than with previous treatments. Sometimes they worry it’s because they used “the other one” (Dysport or Xeomin) or that “it was diluted” or that “maybe it was old”. Although these worries are understandable, I want to assure you that none of these are accurate and education here is key!

Correct dosing of Botox, Dysport, or Xeomin is part science and part fine art and varies based on each individual need and situation. And although your dosing maybe be similar at each appointment, your results may not always be the same. There are a multiple reasons for this.

First let’s address those worries that I’ve heard over the years, and then we’ll discuss a few other reasons why Botox results can very from treatment to treatment.

Is my Botox “diluted?” Botox, Dysport and Xeomin are all reconstituted with a specific amount of sterile saline according to specific manufacturer guidelines, which our injectors follow exactly. You will not receive any improperly reconstituted or overly diluted Botox, Dysport or Xeomin at Body Tonic.

As far as newness of our products, we perform about 160 Botox appointments each month, which means we are ordering more than 50 NEW vials of Botox, Dysport, and/or Xeomin every month direct from the manufacturers. NEW NEW NEW:)

Do be aware of pricing if you go somewhere else for your neurotoxin, and of course research the establishment and injectors. Deeply discounted product may not be from the manufacturer or may be improperly reconstituted.

As far as the worry that Dysport or Xeomin is “generic” Botox, or that they don’t work as well, that is simply not true. They are equally effective products that are simply made by different manufacturers. Dysport is made by Galderma who makes the Restylane products (Restylane, Lyft, Silk, Refyne, Defyne, Kysse, and Sculptra), and Xeomin is made by Merz who makes Belotero and Radiesse. The active protein in each product is slightly different. It can actually be good practice to switch between all three periodically so your body does not build up antibodies to any one product in particular.

When should you see optimal results? You may not see full effects until 7-10 days post treatment. The other day I caught myself thinking, My Xeomin didn't work! as I stared at my forehead wrinkles. But then I realized it had only been 4 days since my treatment.

Your 2-week follow-up appointment: If you need some tweaking after your treatment, it has to be 10 days post your first appointment. We will not add units before this time. This is a hard and fast rule. The reasoning for this is, for example, that if we do a touch-up on day 7, the results from your initial treatment are likely still kicking in, and adding Botox when the injector cannot see the full effects means you will be improperly dosed, which can lead to less than optimal results.

Other Reasons Your Botox Results Vary.

So, you had your Botox and it’s been 10 days but you still have more movement than you would like. What happened? There are several reasons why:

~The amount of units received

~Timing between Botox appointments



~The possibility your body has built up antibodies to the neurotoxin

Let's break it down:


You might be the type of person who comes every three months for your Botox appointment. And let’s just say life gets in the way and you end up not coming in for another treatment for 8 months. Well, when you are fastidious about your appointments, you will likely use fewer units at each appointment as your muscles will have become weaker. When you wait longer between each appointment, your muscles have time to strengthen again, as Botox wears off. This means you will likely need more units at the next appointment. Trust your injector to tell you how many units you will need to use to achieve the results you are looking for. If you take a chance and use less, you’ll probably be back in a few weeks anyway for more units. (P.s. If you know us, you know our injectors do not overdose or overfill. They err on the side of a natural and subtle result).


If you have started working out more than normal, your body is going to metabolize your product more quickly than if you are less active. After all the product is simply a protein and your body will break it down over time.

Consider Switching.

It is possible to build up antibodies to a neurotoxin over time. If you’ve stuck to all the proper guidelines above: coming for your regular appointments, getting the dosage your injector recommends, and you're still not getting the results you want, try one of the other products. While all three products are from the same toxin, their molecular makeups are slightly different. Try switching back and forth and see if you like the results from one better than the other. We all have our personal preferences!

Be Specific About What You Want.

Some people like to be frozen - they want zero movement in their face. This will require more units than the person who wants a slight brow lift and wants their crow’s feet treated. Be specific about what you are looking for so they know exactly how and where to inject you. Also know that with Botox/Dysport/Xeomin, sometimes you can't get all the things you want in the same treatment due to how facial muscles work. For instance, you may want to have lifted brows, but this also means you may not be able to get rid of all of your forehead lines, because you will need some muscle movement to get that lifting effect.

Be Flexible With Budget.

I know budget can be a very defining issue for medical spa treatments. However, if you are usually on a tight budget, it’s best to wait until you can have SOME wiggle room. Our injectors recommend waiting until you have saved a little extra rather than skimp on how many units you use. Skimping on units used will only get you a lesser result. It’s best to either treat one small area properly, or wait and treat the entire face with proper dosing.

AVERAGE dosing per area (eye area, glabella, forehead) is 20-25 units. That is based on manufacturer guidelines. Of course, everyone is unique and you may require less, or more.

In general, the best bang for your buck is to keep your appointments every 3-4 months, stick to proper dosing, and try switching up the products if you find one hasn't been working for you! Happy injecting!

We generally have specials on injectables once a month: Details on our Monthly Specials Page.

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