Can I become immune to Botox?

Posted on July 29, 2023 | by Donald Conway

With its ability to effortlessly smooth away expression-based wrinkles and fine lines in just a matter of days, it’s no wonder Botox® is consistently the most-used cosmetic injectable treatment. But, since its development in 1989, Botox users have wondered if it’s possible to become immune to its effects over time. In this month’s post, we answer your top questions about Botox resistance.

What is Botox resistance?

Botox resistance is a phenomenon in which a patient is no longer able to experience the full effects of Botox. While it is an exceptionally rare occurrence (it affects less than 1.5% of patients), there are two reasons a person may develop Botox resistance: 1) they have built up an immunity to Botox’s active ingredient, botulinum toxin, or 2) they are able to metabolize the drug exceptionally quickly. Though some patients become completely immune to Botox, most people who develop a resistance will typically still experience its effects, they will just be less noticeable and shorter-lasting. 

According to Botox clinical trial data, less than 1.5% of patients developed any sort of resistance to the drug.

Why am I not seeing my Botox results?

Assuming you’re not resistant to Botox (and you likely aren’t), there are several reasons why it may be taking a while to see your results, or why your results aren’t as profound as usual:

Reason #1: You haven’t waited long enough

While many patients notice fewer wrinkles in as little as 48 hours, it may take up to 10 days to see the full effects of Botox. If you haven’t seen results from your Botox treatment after 2 weeks, contact your provider; a professional medical injector will want to know if you are unsatisfied with your treatment. 

Reason #2: You received an incorrect dose

It’s possible that you received an incorrect dosage of Botox. Under-qualified injectors may lack the training and experience necessary to determine the correct amount of Botox for your unique anatomy, leaving you with underwhelming results. 

It’s also not uncommon for injectors to err on the side of using too little Botox to avoid a “frozen” appearance, knowing that more can later be added to adjust your results. (A qualified provider should discuss dosage options with you prior to treatment.)

Keep in mind that outstanding Botox results are those that help you look naturally more rejuvenated, not like a different person. Oftentimes, this means using smaller doses in some areas and larger doses in others. 

Instead of getting caught up in how much Botox your provider is using, focus on your results: Does your skin look smoother? Are your crow’s feet less pronounced? Do you look and feel more approachable? In the long run, you’ll be much happier with results that do not announce you have had a Botox treatment.

Outstanding Botox results are those that help you look like a more rejuvenated version of yourself.

Reason #3: Your injector missed the mark

It’s also possible that your injector missed your target muscle (the muscle responsible for causing a wrinkle), accidentally injecting Botox into your face’s soft tissues instead. Again, this is why it’s so important to choose an injector who has a thorough understanding of facial anatomy.

Reason #4: You need to account for your skin’s natural aging

While it’s easy to assume that the same amount of Botox will always provide you with consistent results, you will likely need to increase your dosage as you age in order to combat increasing skin laxity, fine lines, and wrinkles. (After all, our skin certainly looks and behaves differently at 40 than it did at 30.)

Can you overcome Botox resistance?

If you believe you have developed a resistance to Botox, we recommend you try spacing out your treatments further. For example, if you have received Botox injections every 3-4 months for the past 10+ years, abstaining from treatments for a while may help your body stop producing antibodies against the complexing proteins that Botox is formulated with. 

You may also try switching to Dysport® injections, as Dysport uses slightly different complexing proteins than Botox. For the same reasons some people prefer Tylenol® to Advil®, some of our Asheville patients prefer Dysport to Botox—and vice versa. 

What is the difference between Botox and Dysport?

Because Dysport is slightly less potent than Botox, the two neuromodulators vary slightly in 1) their dosage, 2) how much they spread once injected, and 3) how quickly they deliver results. While Botox takes about 5-7 days for results to appear and lasts for about 3-4 months, Dysport takes about 2-4 days for results to appear and lasts about 4 months. We are happy to discuss these options with you further during a personal consultation.

Visit board certified plastic surgeon Dr. Conway for your Asheville Botox treatment

To ensure you will be 100% satisfied with your Botox treatments, make sure you choose a board certified plastic surgeon, or a licensed injector working closely with him or her. Asheville plastic surgeon Dr. Donald Conway is certified by the American Board of Plastic Surgery; he performs all of his own cosmetic injections, including Botox and Dysport. You can schedule a Botox consultation with Dr. Conway online or by calling (828) 210-9333.