Botox New Jersey

Bad Botox? Is there such a thing?

If done correctly …very unlikely but it can be operator dependent.

I have seen multiple times in my office patients from other doctors that went for treatments  and have waited about two weeks and still no result!

There are multiple reasons for this. Again, in this blog  what I say about Botox applies to Dysport as well.
Let’s first assume the provider or doctor is ordering either Botox from Allergan or Dysport from Medicis so it’s “real Botox”.

There are other problems that can arise. Let’s also assume it was transported and stored  via refrigerated means. Initially Botox stated  it must be used in 1-2 weeks… multiple studies have came out since showing once mixed it lasts about 4-6 weeks refrigerated.  If it was mixed for 6 weeks or longer  for example a provider who only uses small amounts on limited patients in his practice it may have gone bad. .. so yes bad Botox! I always tell patients to wait ten days to two weeks for full effect especially for Botox. Dysport tends to act quicker so waiting a week to ten days would be appropriate.

So assume you’ve waiting the prerequisite time and you are having a decrease in the muscle movement .. but you still have a wrinkle you may need more units injected. Some patients like to cut back on or say I can only afford this much.. can you spread it out?.. I always say it’s better to treat one area completely than to “spread out” the dose to hit all the areas desiring correction.  The next important consideration is “user dependant” Did they mix the concentration properly? Since it doesn’t come pre mixed… the provider has to mix it and there are different regimens to accomplish this. For the purposes of learning let’s also assume the doctor is giving you exactly what he says he is.  The next and equally important point is placing Botox into the muscles that are  causing the wrinkle….Many times I have patients tell me can you inject it… here and here…. Botox only works if it is injected correctly into the muscle that is pulling at a right angle to the wrinkle. So the answer is …no it can’t effectively treat all lines but it depends on how the muscle is moving.  I spend extra time to determine how a person wrinkles their forehead and have them make funny faces to determine this movement. The frown lines (glabella) move by primarily three muscles that require 5 injections to all parts of the muscle to achieve relaxation. I have been at conferences and believe it or not many doctors inject it in a “V” like the product flyer describes but doesn’t describe the musculature. If its not placed precisely … your not going to get the best result that  can be obtained.

There is such a thing as developing antibodies to Botox. I have only seen a case or two in 6 years but it is reported albeit rare. Also sometimes if someone doesn’t respond to Botox the provider can try Dysport.

Will Botox remove all wrinkles…no.. if after treatment you still have a line and the muscle that causes the line still has movement still have the option of placing more Botox.. If there is no more movment a viable option would be injection of  dermal filler. For more information you may refer to my blog:  Dermal Fillers: Restylane vs Juvederm What’s Best?

Lastly, as always, go to someone who does alot of injections .. like anything else if you do alot of something you”ll  become very good at it and you’ll constantly have a fresh supply of product  because of sheer volume!    -Dr Macri

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