I Tried Getting Botox, and It Never Worked—Until I Made This Simple Change

Meet the Experts: David Shafer, M.D., F.A.C.S., a double board-certified plastic surgeon in NYC; Jennifer Holman, M.D., F.A.A.D., of U.S.Dermatology Partners Tyler in Texas; Ivona Percec, M.D., Ph.D., associate professor of surgery at the University of Pennsylvania Perelman School of Medicine and director of the Cosmetic Surgery Program at Penn Medicine; Gabrielle Garritano, P.A., the founder and CEO of JECT.

None of the brands I’ve tried keep my brow wrinkles sufficiently frozen for more than two months—by week eight, I have deep goat paths from temple to temple. “Most people get three to five months,” confirms David Shafer, M.D., F.A.C.S., a double board-certified plastic surgeon and Allergan Medical Institute (AMI) trainer. (Allergan is the maker of Botox.)

But let’s back up. It is super weird to get shots in your face—it just is. Each time, it’s gone like this: I hop up into a medical aesthetic chair, which is similar to the kind at the dentist’s office. My injector—either a healthcare provider or a trained aesthetician—gives me a handheld mirror and asks what I’m hoping to achieve that day. We joke a little about how if world peace isn’t possible, then maybe a little wrinkle reduction? I point out what I hope to see ironed out (the lines across my forehead bug me the most.) If it’s a new injector, they’ll ask what brand I’ve tried before, and I give them my spiel about none of them lasting, but being ready to try again.

This is me post Botox at week two—you can’t tell but my eyes are wide open and I’m trying to furrow my brow. Spoiler: It didn’t last.

I’ve always had good results, at least at first. No surprised clown face, as one of my friends had before her wedding, and no Angry Bird brows, which happened to my mom when she had tox for migraine. An experienced injector knows where to place the tox for the most flattering effect.

While the injector goes to get the vials, syringes, and an ice pad for after, an assistant will pop in with an iPad and take before pix—straight-faced, smiling, or with my forehead scrunched up in the least attractive way possible; this is for comparison, but also so the injector has a sense of where exactly my facial muscles are.

Finally, the injector fills the syringe, asks me to quickly scrunch my face again, and starts the jabs. And yes, it hurts—more than a blood draw, less than a tattoo—but only for a sec for each spot, and it’s all over in under a minute. When I’m done, I will usually have 12 or so bumps across my brow, an inch or so below my hairline. That’s the tox sitting under my skin, and it gets absorbed quickly.

Then she hands me a small ice pack for the pain and to reduce redness, tells me if she sees a bruise forming (once in a while, a tiny blood vessel gets nicked—it goes away in a day or two). I hand her my credit card.

And that’s it! Any redness goes away in a few minutes for me—no real downtime—but some people like to schedule it for the end of the day just in case. Oh, and I’m instructed not to work out hard, to avoid heat like saunas, and not to mess with heavy-duty skincare such as retinoids for 24 hours. Depending on the brand, things will freeze up in a couple of days to a week, and usually see the full effect after two.

In May 2025, I explained my tox-resistance situation to my provider at JECT. She agreed we should try a higher dose, and suggested Daxxify, which is said to last longer at its FDA-approved dose. (It does, but experts attribute that to the fact that the approved dose is double Botox’s—two units of Daxxify is the equivalent of one of Botox.) She gave me a whopping 70 units.

I was psyched—it worked fast, and there was still some difference at month four.

Four months after 70 units of Daxxify.

It was definitely an improvement, although nowhere near the six months Daxxify’s manufacturer says is typical, at the FDA-approved 40 units. The longer duration was to be expected with a higher dose, says Ivona Percec, M.D., Ph.D., associate professor of surgery at the University of Pennsylvania Perelman School of Medicine and director of the Cosmetic Surgery Program at Penn Medicine, and “probably would have been the case for all of these products,” she says.

The higher dosage worked better than standard, says Dr. Shafer, because “you’re likely a hypermetabolizer.” But since it took me 70 units (close to twice the FDA-approved amount of Daxxify) to get less than the expected results, there had to be something else afoot.

All the experts agreed: While there are differences between brands, and one might be better suited to individual needs, there’s no clear winner.

“It’s a matter of the client’s preference,” says Gabrielle Garritano, P.A., the founder and CEO of JECT, which offers the range in its clinics. (Garritano, a physician assistant, is an AMI trainer and Medical Affairs Clinician for Evolus, the maker of Jeuveau.) They all have high satisfaction rates. “I have all of them in my practice, and patients that say the exact same thing about every single one,” adds Jennifer Holman, M.D., F.A.A.D., of U.S.Dermatology Partners Tyler in Texas.

A double-blind randomized clinical trial this year backs this up: It compared four brands, and found that while two had quicker onset and another lasted longer, “all formulations resulted in significant improvement in strain and patient satisfaction up to 90 days.” (Daxxify and the latest, Letybo, were not included, as the study started before their FDA approval.)

It’s hard to pick a “best” neurotoxin, because each has unique factors that could lead to great—or not so great—outcomes, says Dr. Percec. Jeuveau lasted the longest, for example, but its formulation means it must be injected in the precise right spot in the muscle. Outside of a lab, “I can see someone who is not a great injector or doesn’t understand the importance of placement getting less-than-optimal results with Jeuveau,” she says.

I talked things through with Dr. Shafer. My previous treatment in 2022 had been 20 units of Botox in my frontalis, the large muscle of the forehead, plus 14 at a touchup two weeks later. It worked at first, but by month two, I was back to the before picture.

[Full disclosure: I received complimentary Botox at the Shafer Clinic, as well as Daxxify, courtesy of JECT.]

I could rule out inexperience, improper reconstitution, or a bad batch, which are some of the reasons tox treatment might not last—I was treated by pros. And while I didn’t get tested for the antibodies a tiny number of people develop to tox, Garritano says that’s not why my furrows came back so fast. “I think if you’d developed antibodies, it’s unlikely you’d see such good results at the two-week mark,” she says.

So did I need an elephant-paralyzing dose to still my mighty forehead? Dr. Shafter thought perhaps. “It could be that you were under-treated,” he said. “Maybe you just need more.” Says Garritano: “We know that higher doses lead to longer duration.”

Finally, in September 2025, four months after my Daxxify treatment, I had 50 units of Botox—less than the equivalent of the Daxxify, but plenty. “If you increase the dosage, you increase the duration, but it plateaus at the top of FDA dosing—there’s no reason to go higher,” says Dr. Shafter.

My forehead, three months post 50 units of Botox

Here I am after three months. It’s not all gone, which I’m calling a win.

After talking to Dr. Holman, I think I know why this worked better, and holds promise for the future: Because I had two treatments, only four months apart, my muscles were weakened, I didn’t chew through the tox so fast. “Get a year of treatments every three to four months, and it’ll give your muscles time to rest, and it should start to last longer,” she says. “You may even be able to go down in dose.”

Garritano and Dr. Shafer had both mentioned the importance of being consistent, but I kept thinking, Why? It doesn’t work for me. Now I get it. “Keep at it until the muscles learn to be trained,” says Dr. Percec.

I think I will. Or I’ll get bangs. Or train my face to never express emotion again. Feminism is all about options, right?

Stephanie (she/her) is the executive editor of Prevention and director of the Hearst Health Newsroom. She has covered women’s physical and emotional health, fitness, nutrition, sexuality, parenting and much more for national publications for decades; she is also a bestselling author, a mom of twins and a Mini Schnauzer, and drinks too much seltzer.