Botox Not Working? Here Are 5 Reasons!

In this article I’m going to talk about the five things that make your Botox not work anymore.

Whether you’re a client or whether you’re a provider, the question is why does Botox not work anymore.

You can be a client and you’ve been doing it for many years and all of a sudden you’re like ‘why am I using so much more Botox’ or ‘it just doesn’t work for me anymore’.

Why are you not getting the results that you’re seeking?

Let’s talk about five reasons why your Botox potentially is not working for you.

Botox not working


Number one is tolerance. Like any other medications, over time you may build a tolerance to that. Secondarily, your body might be building antibodies, meaning that whatever medication goes in, your body doesn’t like that foreign substance and puts up an attack against it.

You just need higher doses because your body’s gotten used to it and then secondarily, your body can be building antibodies.

To remedy that, oftentimes we’ll ask you to switch up medications. So if you’ve used Botox your whole life, switch over to Dysport and vice versa.


Number two, and this is one of the big ones, is dosing. Are we using the right dose and are we dosing it correctly in the right area?

Let’s assume you came to me for the very first time and historically you’ve done 20 units of Botox and you tell me it’s just not working for me, I feel it fades in a month or two months.

My first question for you is always where are you putting those 20 units, because if you look at FDA recommendations, 20 units is meant for the frown. 20 units is meant for the forehead and other recommendations based on other areas.

So if you’re taking 20 units and you’re spreading it out all over the place, you’re taking a very small amount of medication and diluting it over a large area.

Dosing equates to longevity and also equates to satisfaction.

Another analogy. I love analogies.

If you had a headache, how many Tylenols would you take? For most of us we would take two Tylenols.

If you decided not to take two Tylenols, but only a quarter of a Tylenol, could you get an effect? Maybe. Will it last as long? Most definitely not, because the recommended dosing is two Tylenols.

Recommended dosing is 20 units of Dysport. If you’re going to dilute that and take less of it, then you’re going to get less results.

There’s some other factors as to why we dose less, but we can discuss that in the future. But dosing equates to longevity, equates to how well the medication works for a specific area.

See: How to Fix Droopy Mouth Corners

Switching Providers

What we commonly don’t think about is switching providers.

Let’s assume, you jump from provider to provider, for whatever reason as a client.

Because it’s medicine, because it’s your muscles, because it’s our educated guess based on our historical data, based on recommendations from the FDA, we assume you need so much medication into a certain area.

Again, 20 units for frown. You come to me and you’re say let’s put in 20 units. But in the back of my mind I know that your muscle is so strong that you probably need 30 units into the frown, but you’re only willing to do 20.

Instead of coming back for the follow-up, you say it didn’t work for me. You jump to a different provider. That same provider might have the same thought process and do the same thing to you.

And rather than coming back and letting that provider learn how the medication affects you, see what you’re going for, you’re always jumping from provider to provider and that provider is trying to figure out what the heck we’re supposed to do with you, how are we going to dose you, how much we’re going to put it, where we’re going to put it.

So always follow up with your provider and secondarily, don’t jump practices unless you have a specific reason why you’re jumping practices, either you were not satisfied with provider or you didn’t like the pricing, whatever the case is.

But if you can stick to that sole provider, so both of you can learn each other, then that’s the best way to do it.

Aging Process

This is for long-term clients. Botox only works on the muscle. So when the muscles contract, they cause wrinkles. Every time you frown, you are causing that wrinkle. Every time you lift your eyebrows, you are causing that wrinkle.

Over time it may not just be a Botox issue or a muscle issue anymore.

Aging process is the loss of bone, the loss of collagen, the loss of muscle, loss of a lot of items.

One of the big items that people come to me for are the crow’s feet. Every time we smile, circular muscle around the eye contracts and pinches the skin right there.

Let’s assume you’re 20 or 30 years old. That’s a muscle issue, every time you smile, it contracts.

But when you age, what happens is you lose volume in your temples and you’ve seen the people when they age their temples become very hollow. Secondarily you lose collagen, which is the glue that keeps your skin nice, firm and tight.

When you hollow, your brows and your skin start falling down and in, so that’s why you get the heaviness in the eyes. When you get heaviness in your eyes you naturally create a fold right there just due to the falling skin.

Secondarily, when you smile, your cheek pushes up against your eyes. You can never fix the upward push because that’s you smiling. Unless we take away your ability to smile, you’re not going to fix that.

But when we’re young, this skin is nice, thick and hearty, so when you smile, the skin goes with it, it moves with that smile.

But when you are 70 or 80 years old, skin is falling, sits on the eye. When you smile, it pushes right up against that weight. Downwards causes wrinkles, upwards causes wrinkles. No amount of Botox is going to fix falling skin.

It might reduce the contraction that occurs but the aging process has now taken over and it’s not just a muscle issue anymore.

Bad Batch

Did I get a bad batch?

It’s medication, I’ve had this happen a couple times, where I’ll have a string of people come back to me and they tell me my Botox isn’t working.

But if i look back on the history, I never had this issue before, but within this certain month, I have all these recurring items. So I’ll look at the batch, I’ll look at the lot number and I’ll see there’s a common theme here.

So if you did 100 units and it just didn’t work like usual, we’ll talk about it and if we come down to the conclusion that it was just based on a bad batch, I’ll redose you, no charge to you.


Those are five major reasons why Botox doesn’t work for you anymore.

Let’s recap.

1. Tolerance to the medication. You’ve just built up a tolerance over time or you develop antibodies that just attacks the medication once it goes in.

2. Wrong dosing, meaning that you just didn’t get the right dose, whether it’s too high or too low. The higher the dose, the more longevity you have and the higher the dose, the stronger the medication is.

3. Switching providers. Whether you’re a new client, you’re an old client, try to stick with your provider the best you can. They get to learn you, your habits, what look you’re going for, and what units you truly need. So unless you have a specific reason to switch clinics or providers, stick with that one provider.

4. The aging process. When you age, bone, fat, collagen, muscle, you lose all those items. So it’s not just a medication issue anymore. Your face will eventually keep falling forward and down. No amount of Botox is gonna resolve loss of those tissue items.

5. Bad batch. Did the manufacturer just give us a bad batch in regards to Botox or Dysport? If that’s the case, no big deal, that’s the easiest fix of all of them. We just redose you.

I hope that helps in regards to explaining why potentially my Botox doesn’t work. There are many other issues, but talk to your provider, always do that follow up, come back in two weeks and inquire why isn’t my Botox working like usual.

Botox Not Working? Here Are 5 Reasons!

One thought on “Botox Not Working? Here Are 5 Reasons!

  1. There are two reasons I feel may apply to me.
    One, I have used Botox repeatedly over probably 30 years or more. I feel I have probably built up antibodies to it just as with having taken all vaccinations and boosters as required and have “yet” to contract Covid for example even though I have been exposed several times. May be genetic in that, however also. and two, I will be 73 in April and it just may be that most all the collagen has nearly disappeared and the muscles just do not respond any longer. The skin is going to be thinner and will continue to sag no matter how much Vitamin C, hyaluronic acid, or retinol and moisturizer I put on my skin. Thank you for the indepth information provided.

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