Botox does not work – what could be the reason?

There are many myths surrounding Botox, such as that Botox makes people stupid. A frequently asked question is why Botox does not work.

One thing right away: Botox does not make you stupid. In the meantime, there are various scientific studies on this. Not so easy to answer, however, is the question of what reasons there are when Botox does not work or the effect can diminish in the long run. Here is a VIDEO INTERVIEW with Dr. Sonja Sattler from the Rosenpark Clinic.

Botox does not work – what are the reasons for this?

“Botulium toxin-A is a well-known drug in medicine. We have been using it in aesthetics since the early 90s in very small doses. If you use a selected product from botulinum toxin-A, the effect is consistent. Nevertheless, there are single, few cases that show antibody formation. However, these patients were usually treated for many years in neurology, where high doses of the drug must be used.”

Does the effect of Botox diminish after frequent use?

“Antibody formation against botulinomtoxin-A is extremely rare in aesthetic medicine. We know very few cases from Korea, however, we have not experienced it in our country so far. It is important to know that there are different botulinum toxin-A products. They do not differ in the active ingredient, but in the so-called additives. There should be as few protein additives as possible in a product, otherwise a similar effect as with a vaccination is caused.

The protein is a so-called adjuvant, whereby the body reacts more quickly to botulinum toxin-A by forming antibodies. Patients are usually treated with Botox for years. That’s why at Rosenpark Clinic and Bellari, we’re extremely careful in our choice of botulinum toxin-A product.”

Can covid-19 vaccination be counterproductive?

“So far, we don’t know if Covid-19 vaccination is counterproductive to botulinum toxin-A. We do know that there can be side effects with hyaluronic acid-based filler products, such as swelling after inoculation. However, we don’t have any science-based numbers to show that Covid-19 vaccination has any effect on Botox treatment.”

Can a cold or other infection affect the duration of action?

“A cold or other infection usually cannot affect the effect. Botox is incorporated into the muscle synapses after five to seven days and then slowly broken down by the body over three to four months. Immunologic events such as the flu or cold cannot affect its effectiveness.”

Is there also the opposite effect, that the duration of action is prolonged?

When we started in the 90s with botulinum toxin-A for treatment, especially of the frown line, we thought that after regular use, the intervals of treatment may also lengthen as the muscle weakens. This is only partially true, as the mimic patterns of each patient are really very genetically implemented, i.e. you never unlearn them. From my 20+ years of experience, I can tell you that I rarely see a lower usage of botulinum toxin over the years.

How important is the quality of the preparation?

The most important thing is to look carefully at which preparation or product you are offered and injected with during a botulinum toxin-A treatment. The purity of these preparations is extremely variable. The German product Xeromin for neurology or general medicine and the product Bocouture for aesthetic medicine are the purest botulinum toxin-A products in the world, with no long-term problems.